SPJI 2013 by Student Psychology Journal of Ireland

student psychology Journal

volume IV

Published by the Student Psychology Journal C/O Department of Psychology, Trinity College, Dublin 2, Republic of Ireland

All views expressed herein are those of the authors and do not necessarily reflect the views of the editors or sponsors.

Correspondance or complaints may be addressed to: Student Psychology Journal, C/O Department of Psychology Trinity College, Dublin Republic of Ireland or email: journal@tcd.ie

The Student Psychology Journal volume IV, as well as previous volumes, are available online at www.tcd.ie.psychology/SPJ

peer reviewers The Committee would like to extend our immense gratitude to the peer reviewers for their time and invaluable input.

Ciaran Benson John Bogue Aisling Bourke John Bradley Jessica Bramham Teresa Burke Joanne Cantwell Samantha Dockray Ciara Mary Greene Olive Healy Eilis Hennessy Rob King Grainne Ni Mhaille Liz Nixon Mike Murphy Redmond Oâ&#x20AC;&#x2122;Connell Mary Parkinson Byran Roche Richard Roche Patrick Ryan Kiran Sarma Annalisa Setti Elizabeth Walshe

the committee

Honorary Treasurer, Dr. Michael Gormley

Co-Editor, Niamh Bergin Co-Editor, Mollie-Kate Richardson General Manager, Nathalie Freysinger Finance Officer, James Larkin Public Relations Officer, Niamh Doyle Design & Publications Officer, Nathalie Freysinger Launch Manager, Rosanne Monteiro

The committe of SPJ 2013 would like to warmly welcome Sally Bourne, Sarah Breathnach, Therese Fitzsimons, Lisa Gannon and Mairead Ryan to the new committee of the SPJ 2014. We are also delighted that Niamh Doyle and Nathalie freysinger will be returning for another year. We look forward to your success.

table of contents Preface Introduction BEST SUBMISSION 2013 Experiences of adolescents in families with a father employed abroad (Denice Cronin & Dr. Lorraine Swords) EMPIRICAL INVESTIGATIONS An exploration of the effects of age and gender on the relationship between alcohol consumption and impulsivity (Siobhan Blackwell and Dr. Teresa Burke)

A comparison of twin and non-twin siblingsâ&#x20AC;&#x2122; use of relational maintenance behaviours and associate measures of sibling liking (Patrice Brennan & David Gogan)

viii ix

Preadolescentsâ&#x20AC;&#x2122; perceptions of cross-gender toy preferences in early childhood and gender atypical behaviour in adolescence: a qualitative exploration (Ann Prendergast)

Effects of cathodal transcranial direct current stimulation (TDCs) on error awareness in healthy older adults (Owen Sheehy)

An investigation of moral development: the effect of religiosity on Kohlbergian moral reasoning (Meg Stapleton)

table of contents

LITERATURE REVIEWS The impact of psychological interventions on mood and coping following 108 moderate to severe acquired brain injury in adults (Maria Leonora Fatimah Agan)

Irish organised crime and the motivation behind gangland killings (Sadhbh Byrne)

119

Are the primary sensory cortices multisensory? (Ciara Devine)

132

A critical examination of the effectiveness of pharmacological intevention for challenging behaviour in individuals with intellectual disabilities (ﾃ（ne Maguire)

144

An account of the neural basis and functional relevance of early cross-modal interactions (Nicholas Murray)

155

Are fathers necessary for positive child development? (Alan Walsh)

164

Culture and mental health: a symbiotic relationship (Sarah-Jane Winders)

176

*This is an amended copy of volume IV. Retracted: Neylon, Karen (2013). A field experiment on eyewitness report. Student Psychology Journal, Vol IV, p. 53-60.

Preface The Student Psychology Journal was established to provide a way of harnessing the outstanding contributions of undergraduate students to our understanding of human behaviour. During the course of their studies undergraduate students produce original and exceptional work but often their potential contributions to our body of knowledge are ignored. We are excited and proud to offer an outlet for Ireland’s psychology undergraduates. The materialisation of the 2013 SPJ has allowed for progress, which includes: the implementation of new cover art and graphics and the most works published in the history of the SPJ. I would like to extend thanks on behalf of all those involved in SPJ 2013, to our generous sponsors, The Open University, Trinity College, and the DU Psychology Society, for their continued support. I would like to express the gratitude of the committee for the guidance of Dr. Michael Gormley, which was essential to the success of this year’s journal. Our thanks also go out to Dr. Ian Robertson for launching the 2013 edition of the Journal. Lastly, I would like to thank the committee for their positivity and dedication to the project. To Mollie and Niamh B., our fearless Editors, who together read over 40 submissions and also liaised between peer-reviewers and authors for 6 months, ‘thank you’. We are also grateful for the hard work put in by our Finance Officer, James, who managed to raise enough funds for the Journal to carry on for another year, a truly arduous task. Thank you Niamh D., Public Relations Officer, for the excellent work keeping note of committee happenings, managing our internet presence, and communicating between the Committee and Psychology departments throughout Ireland. Rosanne, our Events Manager, well done on the Launch Night, you did an excellent job securing all the necessary aspects for a successful event, from your choice of speaker to the procurement of snacks and refreshments. I hope you enjoy the 2013 Student Psychology Journal, Nathalie Ann Freysinger General Manager and Design/Publications Officer, 2013

from the editors The field of psychology has developed exponentially since its naissance. Perhaps something similar could be said regarding The Student Psychology Journal. The Journal, now in its fourth year of publication, was originally founded in 2010 by a group of students from Trinity College Dublin, who recognised the lack of opportunity for psychology students to publish their undergraduate work. The Journal opened its sleeves to all undergraduate students in Ireland the following year, thus allowing the Journal to truly showcase the enthusiasm and talent of Irish undergraduate psychology students. This year the SPJ has flourished further and has afforded more students than ever the opportunity to have their exceptional work recognised. The SPJ remains Irelands only student lead initiative dedicated solely to providing an outlet for the outstanding contributions that Irish undergraduate students offer to our understanding of human behaviour. It seeks to encourage students to have confidence in their academic abilities from the very onset of their psychological craft, while also providing them with a chance to have their voice heard by the psychological community. Further, an ambition is held, that by providing a platform for their scholarly work to reach the psychological community, a taste for knowledge, a keen interest in research and an appreciation for academia will be nourished. Open to all psychological works from discursive essays to qualitative reports it is felt that the SPJ represents the vast scope of interests as well as the ability and enthusiasm that Irish students have to offer the discipline. This yearâ&#x20AC;&#x2122;s edition maintains a high calibre of work, with the papers written by students of psychology in all years of their undergraduate degree from several different institutions. Following on from previous editions, this yearâ&#x20AC;&#x2122;s publication is divided into two sections; the first contain empirical reports, the second review articles. The articles included cover an array of pertinent topics within the modern world of psychology, with articles focusing on the impact of culture on health, fathers working abroad and error awareness in older adults to name but a few, with papers written by students in all stages of their undergraduate degree and from numerous institutions across Ireland The SPJ 2013 exemplifies the hard work of numerous authors, the support of countless supervisors and faculty members, the expertise of many reviewers and the resolve of a truly dedicated committee as well as the invaluable guidance and direction of Dr. Michael Gormley. To all mentioned we would like to extend our thanks and express sincere gratitude, as without whom the SPJ would not have been possible. We hope that the SPJ continues to excel, providing student with a platform to publish their first work, as well as a forum for all those with an interest in psychology to gain access to the innovative work of undergraduate students. We trust that the support of the journal will only strengthen with time and will presently become an outlet for undergraduate endeavours onto which all students, their supervisors, and associated faculties look upon with pride. Niamh Bergin and Mollie-Kate Richardson Editors, 2013

key sponsor, the open university

Best Submission, 2013

Kindly Sponsored by DU Psychological Society

Student Psychology Journal, 2013, 2-18

Experiences of Adolescents in Families with a Father Employed Abroad Denice Cronin and Dr. Lorraine Swords Trinity College, Dublin Correspondence: denice.c@hotmail.com

abstract

The economic recession faced by Ireland in recent times has compelled some parents to look at employment options overseas. The present study aimed to gain an insight into the experiences of families with a father employed abroad due to the current economic climate. The experiences of adolescents were explored through an inductive qualitative approach. Seven adolescents (5 female, 2 male), ranging in age from 14 to 18 years, participated in semi-structured interviews. Thematic analysis was carried out on transcribed interviews with the themes identified leading to a depiction of these adolescents’ experiences. Respondents described changes in the roles and relationships within their family, and an increase in their concern for other family members. Negative emotions associated with having a father employed abroad were also highlighted, though ultimately, respondents described becoming accustomed to their modified family arrangement. The adoption of coping strategies was conveyed, with respondents asserting that ‘life goes on’ despite the intermittent absences of their father. The findings of this study suggest recommendations to help alleviate the impact of intermittent father absence, and provide a foundation from which to explore methods to support families confronted with such situations.. Introduction The economic recession faced by Ireland in recent times has placed increased financial strain on many families (Watson, Maître, and Whelan, 2012). A UNICEF

Ireland (2011) report indicated an overwhelming majority of Irish young people identified direct effects in their home life as a consequence of the recession, with 25% of 16 to 20 year olds declaring a family member as ‘recently unemployed’.

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD Current employment difficulties in Ireland have compelled some fathers to look at employment options overseas, often leaving their families at home in Ireland. During times of economic recession, having a reduction in disposable income can constitute a time of increased financial pressure, and negative changes in parental mental health, marital discord, and parenting quality (Solantas, Leinonen, & Punamaki, 2004). Employment-related father absence may bring economic benefits to the family, and thus, alleviate financial pressure and some of these consequential negative outcomes. However, it remains uncertain whether the financial positives associated with being employed abroad, outweigh any negatives relating to having a father intermittently absent from the household. Father absence may be attributed to many factors, and some fathers may be absent from intact families for intermittent or temporary time periods (East, Jackson, & O’Brien, 2006). Employment-related conditions are commonly associated with this form of temporary father absence. Fathers in a range of occupations such as the military, offshore oil and fishery workers, miners, and workers in the transportation industry may find themselves geographically separated from their families (Forsyth & Gramling, 1990; Riggs, 1990; Tanaka & Nakazawa, 2005). Western psychological research on the effects of father absence has primarily concerned itself

with parental turmoil and death, circumstances that can have diverse outcomes on children and adolescents (Hetherington & Stanley-Hagan, 2003; Lamb, 1997). It has been suggested that the favourable interactions that a father engages in with their family have a greater association with children and adolescents’ positive development than the actual amount of time fathers spend with their children (Amato & Gilbreth, 1999; Hawkins, Amato, & King, 2007; Patterson, 2006). Father absence alone due to employment-related circumstances may have a limited negative effect on children and adolescents. However, the frequent partings, separations, and reunions associated with families who have a father intermittently absent, may elicit a number of changes in family life and impact on family members’ wellbeing (Flake, Davis, Johnson, & Middleton, 2009; Jensen, Grogan, Xenakis, & Bain, 1989). Maternal wellbeing may be influential in predicting children’s adaptation to their father’s intermittent absences (Andres, & Moelker, 2011; Palmer, 2008). Emotional and psychological effects, such as increased anxiety and loneliness, as well as difficulties and stressors related to child rearing, have been self-identified by spouses during their husbands’ temporary absences (Blount et al., 1992; Diamond, Hicks & Otter-Henderson, 2008; Eaton et al., 2008). Wheeler and Torres Stone (2010) found that mothers with spouses working abroad in the military described

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their household as resembling that of a one-parent family. Military mothers additionally reported an increased domestic role overload and difficulty involving their spouse in events they missed during the time they were overseas (Wheeler & Torres Stone, 2010). However, the resilience of mothers was portrayed by the successful development of coping strategies during these times, such as increased self-sufficiency and confidence in their abilities to run a single-parent household (Wheeler & Torres Stone, 2010). Mothers with intermittently absent husbands working in the mining industry reported significantly increased stress levels and disruptions to family routine (Kaczmarek & Sibbel, 2008). However, no difference was found on measures of their children’s psychosocial wellbeing when compared to military and control families, and all children were considered to be functioning at healthy levels (Kaczmarek & Sibbel, 2008). Researchers speculated that athome mothers had developed protective mechanisms by experiencing the intermittent father absence lifestyle, and were able to promote equilibrium and stability in the family system, thereby supporting the wellbeing of their children (Kaczmarek & Sibbel, 2008). The role of employment-related father absence as a specific factor affecting family cohesion and children and adolescents’ wellbeing has been researched in Japan. These studies have involved inves-

tigating ‘Tanshinfunin’, a Japanese concept describing temporary father absence due to job relocation without their families. Comparison studies have examined ‘taidofunin’, where families relocate with their father as a unit (Bassani, 2007; Tanaka and Nakazawa, 2005). In comparison to ‘taidofunin’’ families, children experiencing temporary father absence depicted a more negative and lonely atmosphere in their home, and exhibited an increased allowance for deviation of social norms and early delinquent behaviours (Nakazawa, Tanaka, & Nakazawa, 1998). ‘Tanshinfunin’ children also recounted positive coping behaviours through establishing a strengthened relationship with their mother, and by playing a greater role in the running of the household. Conclusions from data collected on ‘tanshinfunin’ job transfers indicated that the physical absence of fathers alone does not have a direct negative effect on parent-child relations, families’ overall wellbeing, or children’s socio-emotional development. However, physical absence in addition to functional absence, characterised by a poor performance in a father and husband role, may lead to an increase in children’s problem behaviours and increased anxiety and stress in mothers at home (Nakazawa, Tanaka, & Nakazawa, 1998; Tanaka & Nakazawa, 2005). Western research has also suggested that father absence may only be harmful when certain aspects of the father’s role remains unfulfilled or inadequate, specifically factors that are crucial to family functioning such

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD as social, emotional, and economic support (Carlson, & Corcoran, 2001; East, Jackson, & O’Brien, 2006; Hetherington, & Stanley-Hagan, 2003; Hiew, 1992). Empirical research has shown that temporary father absence may indeed elicit positive changes in adolescents such as increasing maturity and self-sufficiency, and resulting in more cooperative and responsible attitudes at home (Huebner & Mancini, 2005). Many children were seen to recognize the positive aspects of having their father employed abroad, particularly the fact that their fathers spent an increased amount of time with them when they were home (Houghton, 1993; Parkes, Carnell, & Farmer, 2005). Although most adolescents reported feeling the strains of having their father intermittently absent, many believed that there was no irreparable damage to their family ties and functioning, and were quick to defend their transnational family unit (Parrenas, 2008). The majority of mothers in military families believed their children rapidly adapted to their father’s temporary absences, particularly those who exhibited an understanding of the reasons behind their fathers’ absence (Andres & Moelker, 2011; Flake, Davis, Johnson, & Middleton, 2009). Similarly, spouses of UK offshore workers reported that their families had adapted in a relatively favorable manner to the changes in family life associated with having a parent working offshore (Parkes, Carnell, & Farmer, 2005).

With a family member frequently absent from the household, the family as a system must manage both their presence and absence (Huebner, Mancini, Wilcox, Grass, & Grass, 2007). Even if absences are not prolonged, frequent absences of a father may place strain on the family system as continual partings, separations, and reunions may result in the repeated reorganisation of a family’s roles and responsibilities (Boss, 1999; Peebles-Kleiger & Kleiger, 1994). The concept of family boundary ambiguity provides a useful conceptual lens to examine intermittent father absence (Boss, 1975). Broadly defined, family boundary ambiguity is “a state in which family members are uncertain in their perception about who is in or out of the family, and who is performing what roles and tasks within the family system” (Boss & Greenberg, 1984, p. 536). Although boundary ambiguity was defined with families experiencing traumatic loss in mind, Boss (1980) highlighted the potential for its utility in studying more common boundary changes across the family cycle, such as parental divorce or when adolescents move out of the home. In families that have fathers who are frequently absent due to work commitments, boundary ambiguity is thought to be particularly salient, resulting in blurred family boundaries, and confused roles and responsibilities (Huebner et al., 2007; Mauthner, MacLean, & McKee, 2000; Zvonkovic, Solomon, Humble, & Manoogian, 2005). Through descriptions of modifications in

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their roles, routines, and responsibilities, adolescents with deployed fathers have alluded to the fact that issues related to boundary ambiguity may arise (Huebner et al., 2007). The Present Study. Although previous literature has investigated employment-related father absence in occupations such as the military, the experiences of families in Ireland with a father intermittently absent have never before been explored. Hence, the current study aims to address this by gaining an insight into the experiences of Irish adolescents who have a father working abroad due to the downturn in the economy. Research in this area is important in order to acknowledge any impacts that this family structure has on family life and family members’ wellbeing. Enhancing our understanding of how employment-related father absence affects families will facilitate efforts to promote beneficial policies for families with a father employed abroad. Adolescents are placed between parents and younger siblings at an intermediary level, thus may be in a position to outline their own experiences, in addition to any differences they perceive in their younger siblings and parents since their father began working abroad. It is hoped that the use of semi-structured interviews will provide adolescents with the opportunity to share these experiences. Through the use of an inductive qualitative design,

the present study intends to help frame expectations for families with fathers considering employment options overseas. Thus, thematic analysis will be employed to summarise and represent the data in a manner that is readily accessible to the general public (Howitt, 2010). The present study is exploratory in nature, but endeavours to reveal the experiences of adolescents in families with a father employed abroad. Method

Respondents. Seven adolescents, two male and five female, participated in individual interviews. Respondents’ ages ranged from 14 to 18 years, with a mean age of 16. Respondents were recruited through an online blog on the Irish Times ‘Generation Emigration’ website detailing the objectives of the study, participation criteria, and contact details of the researcher (Cronin, 2012). All of the respondents were Irish and currently had their paternal parent employed abroad. Inclusion criteria required fathers to be overseas for at least two weeks at a time, beginning in the previous three years. Materials. The researcher prepared a semi-structured interview schedule. The School of Psychology Research Ethics Committee in Trinity College Dublin granted approval for the use of the interview schedule in the study. A review of previous literature surrounding intermitt-

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD father absence informed the general areas addressed by the interview schedule, which included questions covering; •The family’s current arrangement and background information •Any differences noticed in the home, family members, and themselves since their father began working abroad •Advice for a family contemplating a similar arrangement Respondents received information sheets and consent forms prior to participation. Following participation, debriefing forms were provided, with contact details of the researcher and support services available. Interviews were audio recorded using the ‘Voice Memos’ application on an Apple iPhone 4S, and recordings were subsequently transferred onto an Apple MacBook Pro for transcription and analysis purposes. Procedure. Pilot study. Two interviews were carried out for the pilot study to assess the approximate timing of participation, as well as to ensure the suitability and clarity of the interview schedule. The pilot study suggested that the interview schedule and approach worked well. On review, amendments were made to the phrasing of some interview questions to facilitate respondents’ clearer understanding of what was being asked.

Present study. A mutually convenient

time was arranged for the researcher to visit respondents’ homes to conduct the study. Specific and detailed information pertaining to the study design and the participation requirements was provided to adolescents and their at-home parent. Participants were given this information both verbally, and through the provision of an information sheet, prior to requesting written consent. During this time respondents were invited to discuss any queries or concerns they had with the researcher. Upon receipt of written consent from parents and adolescents, adolescents were interviewed in a quiet, distraction-free room with the door open and a parent nearby in their home. The interviewer positioned herself adjacent to respondents in an attempt to create an unintimidating atmosphere. Respondents’ anonymity was reiterated, as was the fact that the interview would be audio recorded. Respondents were reminded that they were free to withdraw from participation at any point. Once verbal assent was obtained, the recording device was turned on and the interview proceeded in accordance with the semi-structured interview schedule. Interviews were open and flexible, facilitating adolescents to describe their personal experiences, whilst allowing the researcher to elicit follow-up information. Interviews ranged from 11 to 26 minutes each in length, with a mean interview time of 17.28 minutes. Finally, respondents were encouraged to voice any queries or conc-

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erns, before being thanked and subsequently provided with a debriefing form. Data Analysis. Interviews were transcribed verbatim, and verified with the original audio recordings for accuracy. To ensure anonymity, respondentsâ&#x20AC;&#x2122; names were replaced with pseudonyms and all identifying information was removed from transcriptions. Thematic analysis, a qualitative data analysis procedure used to identify, analyse, and report patterns or themes emerging from a data set (Howitt, 2010), was used to analyse the interview transcripts. The analysis was data-driven and searched for semantic themes through a cyclical and recursive interpretation process in accordance with the guidelines outlined by Braun and Clarke (2006). Initial codes were generated through immersion in the data, after reading and rereading the transcriptions several times in their entirety. Placing annotation in the right margin of transcripts highlighted initial impressions and interpretations, and codes were noted in the left margin. A list of codes generated from all of the transcripts was produced, and similar codes were then sorted into initial themes. These were subsequently condensed, placing alike themes together, and finally reorganised, reduced, and reviewed, ensuring each theme was easily distinguishable. An appropriate name for each theme was then determined.

In keeping with the principles of qualitative research methods, the analysis included codes mentioned by a minority of respondents in an attempt to account for the complexity in the data. Codes were not predetermined by the researcher but were grounded in the data through creating codes of recurrent topics and concepts. Reliability. The interview schedule was designed around research into the experiences of families with a father working abroad, thus grounding the questions in previous research in the area of temporary parental absence. The aforementioned pilot study allowed for a review of the interview schedule, leading to slight modifications being made. Internal validity was assessed through an independent researcher examining the coded transcripts, deriving themes and labels that they saw fit. Subsequently themes and subthemes were discussed with the researcher. The researcher was consistent in their approach to interviewing adolescents and care was taken to avoid leading questions. The researcher intended to avoid misinterpretations of responses in the interview through asking follow-up questions and exploring them further when necessary. Any instance where it seemed possible that the researcher had influenced a response was excluded from the analysis. Reflexivity

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD It is important to note that the researcher’s father was employed abroad, and overseas for up to three months at a time due to the economic downturn in Ireland. Every effort was made to ensure this shared experience did not allow any preconceptions or biases to impact on the study in any way. The researcher made an entry in a reflective journal after each interview, outlining any impressions or opinions that had emerged. This additionally allowed the researcher to monitor any feelings or preconceptions they became aware of that may have impacted on the

data.

Thematic Analysis. Following thematic analysis of the data, five overarching themes were identified. The accompany-

ing sub-themes noted within four of these main themes are outlined in Table 2.

Analysis Background Context of Families. A summary of the responses gathered through preliminary questioning addressing respondents’ family structure, and their father’s patterns of absence from the home, can be seen in Table 1. Respondents invariably indicated that it was financial factors, and the lack of employment available in Ireland, that compelled their father to begin working abroad.

‘Life Goes On’. Respondents indicated that ‘Life Goes On’ for their families despite their father’s employment-related absences. Adolescents mentioned how through a process of adjustment, they had become accustomed to their modified family arrangement. Adolescents also identified many aspects of their lives that remained constant. Adjustment. Although acknowledging

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aspects of family life that had changed, respondents described how they had become accustomed to having their father working abroad. Respondents indicated that things began to feel normal and that family members soon became ‘used to the situation’. Most adolescents described that adjusting to their father’s intermittent absences was ‘easier than [they] thought it was going to be’, and that they would advise others that ‘it’s really not too bad having a parent away’. “At the start you take it for granted that you have two parents at home. Like it’s normal that you have two parents at home, but now, it’s normal that he’s away. It’s just a normal daily routine like anybody else.” (Rachel) Continuity. Adolescents indicated that many aspects of their daily lives continued in the manner they were before their father began working away, particularly aspects of their lives outside of their family, such as their social and academic pursuits. “We kind of do the same things as we did before he left.” (Kathie) “We miss him a lot but nothing much has changed. We still live the same lives and we miss him, but we do the same things and get on just as well.” (Robyn) Changing Family Dynamics. Adolescents identified changes in their family

dynamics since their father began working abroad. Respondents specified how family members’ roles and responsibilities shifted, and described how relationships within the family were altered. Shifting Roles. Adolescents described changes in their family’s roles, routines, and responsibilities since their father began working abroad. All adolescents described the requirement to help more at home and many referred to the fact that responsibilities and chores that their father was previously accountable for, were now being carried out by other family members. Some adolescents alluded to the fact that a few of their father’s roles remained unfulfilled in his temporary absences. These included his role in providing specific guidance and advice in domains their mother is unfamiliar with, and his role as a second parent available to drive them to extra-curricular and social activities. “We definitely have to help [mum] out more. She can’t be everywhere so we need to do what she can’t do really…And I guess things that [dad] would do we all kind of do.” (Robyn) Adolescents relayed some difficulties encountered when their father comes home and is unfamiliar with the new roles and routines the family has adopted. Some adolescents described how they are accustomed to only having their mum around, and may find it ‘annoying’ when their

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD father is home and additionally taking on a parenting role. “We’ve gotten used to just having mum and we don’t really need him around as much as he would like…Like we have different responsibilities and stuff and then [dad] kind of comes home and he’d be like ‘oh, you have to do this’, and we’re like ‘ya, we already do that in general so there’s no point in you telling us’, and then he gets annoyed.” (Laura) Changing Relationships. All adolescents recounted how they have become closer to their mother and siblings since their father began working away, and many attributed this to the increase in time they spend together. Most adolescents also indicated feeling like they were drifting apart from their father. “When he comes home it’s really weird…before I would be closer to my dad, but now I’d say I wouldn’t be close to him. Nowhere near as much as I was, I’m better with mum now like…I’d feel like if we were together what do we talk about.” (Rachel) Emotional Repercussions. Respondents associated certain emotions with having their father routinely absent from the home. Adolescents described how they miss their father whilst he is abroad, as well as expressing feelings of anxiety and ambiguity relating to his employment

overseas. ‘We Miss Him’. Adolescents frequently mentioned how much they miss the absent parent whilst he is abroad, and notice how other family members feel similarly. Most respondents additionally mentioned how they particularly miss the presence of their father, or spouse, at important events and milestones such as birthdays and school performances. “There’s sometimes when maybe you just want a hug and you really miss him and you sort of feel that he’s away for most of your life.” (Shane) Anxiety & Ambiguity. Adolescents suggested feelings of worry and uncertainty, in terms of when they would see their father next, what their father’s life and job were like abroad, and what the future would hold for their family. Adolescents expressed worry for their father’s personal safety whilst he was abroad. “You’re always a bit worried and cautious about what’s going to happen to dad when he’s away in a foreign country. Like if anything bad happened or anything he’s so far away from you…when he’s home you feel sort of a bit safer and you don’t have to worry so much.’’ (Shane) Concern for Family Members. Respondents indicated that they pay careful attention to the wellbeing of their family

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members, and described how changes in family members’ emotions and behaviours elicited their concern. All adolescents were aware that their mother was ‘overwhelmed’ and ‘tired all the time’, noticing her increased loneliness and stress levels. Adolescents recognised that it’s particularly hard on their younger siblings. Some adolescents also voiced concern about their father and expressed that ‘they miss you as much as you miss them’. “Sometimes I feel a bit sorry for mum when she’s doing everything…I think that she’s more stressed cause she has to do everything and she gets a lot more tired easier.” (Chris) Coping Strategies. Respondents indicated that they have employed some positive coping strategies in adjusting to their father’s employment abroad, particularly through focusing on the positive aspects of their family’s current situation, as well as seeking support from family and friends. Focus on Positives. Adolescents demonstrated a level of understanding about the reasons behind their father’s current employment abroad, and readily commented on the positive aspects of their family situation. Respondents described how they ‘make the most of the time’ they have with their father in between his time abroad, and how they appreciate that he focuses all of his time on his family when

he’s home. Respondents also described how with their father’s income they are in a position to continue their previous lifestyle, and many now go on more family holidays. Respondents outlined the positives associated with taking on more responsibilities in the home, describing an increase in family members’ independence, maturity, and self-sufficiency. “I didn’t mind him going cause I knew it would benefit us all…It was the best solution for us…I knew it would be a change, but it would be a positive change, and I had to look at it that way.” (Amy) Support Seeking. When anxious or stressed, some adolescents described seeking support from family members. Other adolescents mentioned the benefits associated with consulting friends in a similar situation, with a family member employed abroad, for advice and support. “Three of my friends have parents that go away so if I’m kind of struggling I talk to them about it.” (Laura) Discussion The aim of this study was to gain an insight into the experiences of families with a father working abroad for reasons related to the current economic climate. Specifically, the experiences of adolescents were explored. The themes and accompanying sub-themes identified in the

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD analysis contribute to a depiction of respondents’ experiences. Findings revealed some commonalities in families’ experiences, with each respondent describing modifications in their family’s roles, responsibilities, and relationships, though ultimately indicating ‘life goes on’ despite the intermittent absences of their father. The themes indicated that changes occurred in family dynamics as a result of a father’s temporary absences. However, respondents described how many aspects of their lives remained constant, and family members seemed to adjust and become accustomed to the temporal and spatial distance that defines transnational family life. Respondents described reallocating the roles and responsibilities that their father was previously accountable for to other family members. Peebles-Kleiger and Kleiger (1994) similarly reported that frequent absences of a family member result in the repeated reorganisation of a family system’s boundaries and role assignments. It appears mothers primarily take over these new roles. Adolescents described an increase in their mother’s irritability and stress levels, but also alluded to the key supportive role that their mother plays when their father is intermittently absent. Thus, the way in which mothers deal with this increased stress and workload may prove influential in predicting the overall adjustment of their families.

Respondents described the negative

emotions associated with having their father routinely absent from the home, often mentioning how much they missed them whilst they were abroad. Some adolescents spoke highly of consulting peers who are experiencing a similar family structure, implying that it was valuable to seek support from people who are able to relate to their situation. Establishing support groups for families with a father working abroad would perhaps prove beneficial. An online forum may be effective, as there could be a limited number of eligible families in the locality due to the relative uniqueness of this situation. By providing appropriate support systems to the at-home parent, and by encouraging them to model positive coping strategies, mothers may be less anxious and stressed, alleviating some of their adolescent’s concern for them. In accordance with the concept of boundary ambiguity, Boss (2004) contended that to healthily adapt to a family member who is frequently absent, one should gradually disconnect with them, whilst reconnecting with another available and caring person. Respondents in the present study described how family relationships are altered in a comparable fashion when their father is routinely absent from the home. All respondents depicted how the relationships between family members at home strengthen as they simultaneously simultaneously adapt to life without their father’s everyday presence. Most adolescents indicated feeling like they were drif-

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ting apart from their father. However, respondents also gave positive accounts of being reunited with their father on his return visits. These conflicting depictions of the shared relationship between adolescents and their fathers working abroad, may be an insight into the contradictory feelings adolescents have towards their intermittently absent father. It was beyond the scope of the present study to investigate if having a father working abroad could result in a permanently strained father-child relationship. However, this highlights an important area for further research. Heubner et al. (2007) commented on the fact that adolescents are expected to assume various roles and responsibilities during their father’s absence, and often relinquish these roles whilst their father is temporarily home. Findings from the present study indicate a similar pattern of role allocation. This may place confusion on adolescents regarding their place in the family system (Boss, 2006). Adolescents depicted becoming accustomed to life without their father’s everyday presence, particularly when his absences are prolonged. Some adolescents described issues with the reintegration of their father upon his return, implying that having him home upsets the balance of roles and responsibilities that has been achieved. Adolescents additionally indicated how complying with their father’s parental role and authority could initially prove problematic. By ensuring adolescents are aware of

the expectations for their new roles, and whether they are temporary or relatively permanent, issues related to boundary ambiguity may be reduced. Fathers returning home should anticipate changes that may have occurred in family life during their absence. However, through encouraging family discussions and a renegotiation of rules and responsibilities, families may be better able to readapt when reunited with their father. Respondents made it apparent that they pay careful attention to the wellbeing of their family members, and revealed having an increased level of concern for them. Adolescents attentively identified an increase in their mothers stress and tiredness, and findings suggested that mothers might be unaware of how closely their adolescents monitor their behaviours and emotions. Similar to results reported by Huebner et al. (2007), adolescents were also concerned about how their younger siblings were coping with having their father intermittently absent. Some adolescents noticed changes in their younger siblings’ sleeping patterns and irritability, particularly at times when their father comes home and leaves again. This may be illustrative of the emotional demands associated with the repeated partings and reunions of a parent (Peebles-Kleiger & Kleiger, 1994). Adolescents face normative stressors associated with puberty and academic transitions, and may thus be considered particularly vulnerable in fami-

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD lies with a father working abroad. However, Andres and Moelker (2011) reported that younger children tend to experience more adjustment problems. The present findings tentatively support this claim as adolescents implied they believed it was hardest on the youngest members in their family, though further investigation into this is warranted. Adolescents demonstrate that they are aware of the underlying factors that have led their father to begin working abroad and focused on the positive aspects of their father’s employment circumstances. This may prove beneficial, as Andres and Moelker (2011) concluded that children who exhibit a level of understanding of the reasons behind their father’s absence are better able to adapt. The ability to recognise the positive aspects of having their father working abroad may help adolescents to alleviate any potential negative feelings towards their parents or their current familial arrangement. Respondents indicated that their families continue to function whilst their father is working abroad, adjusting appropriately to new structures and roles, and demonstrating resiliency in their ability to adapt to changes in family life. The present findings are in line with previous research concluding that most families adapt relatively favourably to the demands and challenges associated with having a parent work abroad (Andres & Moelker, 2011; Flake, Davis, Johnson, & Middleton, 2009; Parkes, Carnell, & Farmer,

2005). Limitations and Recommendations for Future Research. The findings should be interpreted with caution as the sample size demarcates the generalisations that can be drawn. Recruitment through advertisement may have resulted in a particular sample of adolescents whose personality characteristics make them amenable to speaking about their experiences and engaging with current research. Data generated in the interviews is taken to represent respondents’ perspectives and not objective fact. Thus, the reliability of the findings from these respondents cannot be asserted or assumed for others. Although the present study may not fully capture the adjustment of all adolescents in Irish families with a father employed abroad, it is hoped that this exploratory work can be utilised to inform future research. The impacts of having a father work abroad have been thought to vary depending on the child’s age, the duration and regularity of the father’s absence, as well as the frequency of the father’s contact and time at home (Boss, 2004; Mauthner, MacLean, & McKee, 2000). Exploration of these factors in future research would enhance our understanding of the experiences of families with fathers working abroad. Subsequent quantitative research might develop the broad observations

Student Psychology Journal, Volume IV CRONIN & SWORDS

identified in the present study. The inclusion of an appropriate category in national population surveys such as the Census may be an important step towards looking into this family circumstance, providing an estimation of the number of Irish fathers who work abroad. It would additionally be interesting to explore father’s perspectives of being intermittently absent from their family. Some respondents alluded to the fact that it may be particularly hard on fathers, adjusting to a new job and foreign country without other family members nearby, and coming home to a family that has become accustomed to his absence. Despite the fact that participant recruitment was not exclusive regarding the gender of the parent working abroad, the sample included only families in which the father worked overseas. A comparison between the experiences of families facing maternal and paternal intermittent absences would be an interesting avenue for future investigation. Conclusion The empirical data presented in this report is not necessarily a definitive narrative of every adolescent’s experiences of having a father intermittently absent. However, considering the experiences of families in Ireland with a father working abroad have been largely neglected in the literature, these limitations should not reject the key findings highlighted in this study. When the composition of a family

alters as a result of having a father working abroad, routines and responsibilities must be adjusted, and relationships within the family may change. However, adolescents seem to be adaptable and resilient, becoming more attuned to the wellbeing of others in their family. Respondents were determined to present their situation in a positive light, emphasising that they had become accustomed to their modified family structure. The findings of this study suggest recommendations to help alleviate the impact of intermittent father absence, and provide a foundation from which to explore methods to support families confronted with such situations. References Amato, P. R., & Gilbreth, J. G. (1999). Nonresident fathers and children’s well-being: A meta-analysis. Journal of Marriage and the Family, 61, 557573. Andres, M. D., & Moelker, R. (2011). There and back again: How parental experiences affect children’s adjustments in the course of military deployments. Armed Forces & Society, 37(3), 418-447. Bassani, C. D. (2007). The Japanese Tanshifunin. Community, Work and Family, 10(1), 111-131. Blount, B. W., Curry, A., Jr., & Lubin, G. I. (1992). Family separations in the military. Military Medicine, 157, 76-80.

Empirical Investigations

ADOLESCENTS WITH FATHER EMPLOYED ABROAD Boss, P. (1975). Psychological father presence in the missing-in-action (MIA) family: Its effects on family functioning. In Proceedings of the Third Annual Joint Medical Meeting Concerning POW/MIA Matters. San Diego. Boss, P. (1980). Normative family stress: Family boundary changes across the lifespan. Family Relations, 29, 445– 450. Boss, P. (2004). Ambiguous loss research, theory, and practice: Reflections after 9/11. Journal of Marriage and Family, 66(3), 551-566. Boss, P. G. (2002). Ambiguous loss: Working with families of the missing. Family Process, 41(1), 14-17. Boss, P. (2006). Loss, trauma, and resilience: Therapeutic work with ambiguous loss. New York: W.W. Norton. Boss, P., & Greenberg, J. (1984). Family boundary ambiguity: A new variable in family stress theory. Family Process, 23, 535–546 Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77-101. Carlson, M., & Corcoran, M. (2001). Family structure and children’s behavioral and cognitive outcomes. Journal of Marriage and Family, 63, 779 –792. Cronin, D. (2012, December 13). What is the impact on children of having a parent working abroad? Retrieved from http://www.irishtimes.com/blogs/

generationemigration/2012/12/13/ what-is-the-impact-on-children-ofhaving-a-parent-working-abroad/ Diamond, L. M., Hicks, A. M., & Otter-Henderson, K. D. (2008). Every time you go away: changes in affect, behavior, and physiology associated with travel-related separations from romantic partners. Journal of Personality and Social Psychology, 95(2), 385. East, L., Jackson, D., & O’Brien, L. (2006). Father absence and adolescent development: a review of the literature. Journal of Child Health Care, 10(4), 283-295. Eaton, K. M., Hoge, C. W., Messer, S. C., Whitt, A. A., Cabrera, O. A., McGurk, D., et al. (2008). Prevalence of mental health problems, treatment need, and barriers to care among primary care-seeking spouses of military service members involved in Iraq and Afghanistan deployments. Military Medicine, 173, 1051-1056. Flake, E. M., Davis, B. E., Johnson, P. L., & Middleton, L. S. (2009). The psychosocial effects of deployment on military children. Journal of Developmental & Behavioral Pediatrics, 30(4), 271-278. Forsyth, C. J., & Gramling, R. (1990). Adaptive familial strategies among merchant seamen. Journal of Family and Economic Issues, 11(2), 183-198.

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Hawkins, D. N., Amato, P. R., & King, V. (2007). Nonresident father involvement and adolescent well-being: Father effects or child effects? American Sociological Review, 72(6), 9901010. Hetherington, E. M., & Stanley-Hagan, M. (2003). The adjustment of children with divorced parents: A risk and resiliency perspective. Journal of child psychology and psychiatry, 40(1), 129-140. Hiew, C. C. (1992). Separated by their work families with fathers living apart. Environment and Behavior, 24(2), 206-225. Houghton, D. S. (1993). Long-distance commuting: a new approach to mining in Australia. Geographical Journal, 159(3), 281-290. Howitt, D. (2010). Introduction to qualitative methods in psychology. Prentice Hall. Huebner, A. J., & Mancini, J. A. (2005). Adjustments among adolescents in military families when a parent is deployed. Final report to the Military Family Research Institute and Department of Defense Quality of Life Office. Falls Church, Virginia: Virginia Tech, Department of Human Development. Huebner, A. J., Mancini, J. A., Wilcox, R. M., Grass, S. R., & Grass, G. A. (2007). Parental Deployment and Youth in Military Families: Exploring Uncertainty and Ambiguous Loss*. Family Relations, 56(2), 112-122.

Jensen, P. S., Grogan, D., Xenakis, S. N., & Bain, M. W. (1989). Father absence: effects on child and maternal psychopathology. Journal of the American Academy of Child & Adolescent Psychiatry, 28(2), 171-175. Kaczmarek, E. A., & Sibbel, A. M. (2008). The psychosocial well-being of children from Australian military and fly-in/fly-out (FIFO) mining families. Community, Work & Family, 11(3), 297-312. Lamb, M. E. (1997). The role of the father in child development. John Wiley & Sons Inc. Mauthner, N. S., MacLean, C., & McKee, L. (2000). My dad hangs out of helicopter doors and takes pictures of oil platforms’: children’s accounts of parental work in the oil and gas industry. Community, Work & Family, 3(2), 133-162. Nakazawa, J., Tanaka, Y., Nakazawa, S. (1998). Tanshinfunin: Effects of father absence on children’s socioemotional development. Annual Report of Research and Clinical Centre for Child Development, 22, 69-77. Palmer, C. (2008). A theory of risk and resilience factors in military families. Military Psychology, 20(3), 205-217. Parkes, K. R., Carnell, S. C., & Farmer, E. L. (2005). Living two lives. Community, Work and Family, 8(4), 413-437.

Empirical Investigations

Student Psychology Journal, 2013, 20-40

An Exploration of the Effects of Age and Gender on the Relationship Between Alcohol Consumption and Impulsivity. Siobhan Blackwell and Dr. Teresa Burke University College, Dublin Correspondence: siobhanblackwell@ymail.com

abstract

This study sought to investigate the relationship between impulsivity and alcohol use behaviours in a university student sample. The secondary aim of the study was to explore whether age and gender influence this relationship. An online anonymous questionnaire, comprising of the Barratt Impulsiveness Scale-11 (BIS-11) and the Alcohol Use Disorders Identification Test (AUDIT), elicited data from 156 students randomly recruited from a university setting, with an age range of 1859 years ( =22.62 years; SD=6.73 years; M:F=1:1.62). The BIS-11 evaluated impulsivity along three second-order traits (attentional traits, motor traits and non-planning traits) whilst the AUDIT determined the extent of current or potential hazardous alcohol use, dependence symptoms and/or harmful alcohol use. Data analysis revealed that a large proportion of students fell within the medium problem drinking range and within the normal range of impulsiveness. A strong association between impulsivity and patterns of alcohol use was observed, independent of age and gender, for both the 18-20 age range and the 21 and older age range. However, impulsivity accounted for only a moderate amount of total variance in alcohol scores. These findings were considered in light of methodological strengths (e.g. validity of measures) and weaknesses (eg. limitations for age balance in a student sample), as well as recommendations for further research and policy actions. Literature Overview

Overview of the research problem.

Stanford et al. (2009) raise the concern that the ability of a person to modulate their cognition and behaviour to fit envir-

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. onmental demands is imperative as most of life’s decisions involve balancing anticipated reward and risk (Zuckerman & Kuhlman, 2000). Understanding the role of impulsiveness for both healthy and harmful behaviours, such as alcohol abuse, is, therefore, of social importance, as once the pattern of gratification becomes habitual, the decision-making process becomes disconnected between opportunity, approach and consummation (Zuckerman & Kuhlman, 2000). Due to the relevance of this topic to current health policies and healthcare practices, the current project set out to uncover the influence of three possible variables, namely impulsivity, age and gender, on the pattern of harmful alcohol use, in a university student sample. Impulsiveness is a complex construct defined as a predisposition of an individual to engage in non-planned, rapid reactions towards internal and external stimuli, without consideration for the possible negative consequences for themselves or others (Moeller, Barratt, Dougherty, Schmitz, & Swann, 2001). A further aspect of impulsivity was outlined by Zuckerman & Kuhlman (2000) as a deficit in the inhibition of dangerous reward-seeking behaviour. Both definitions are reflected in Aragues, Jurado, Quinto & Rubio’s (2011) argument that impulsivity is a heterogeneous construct, encompassing both a reduced capacity of behavioural inhibition and the tendency to choose short-term over long-term gains. Similar-

ly, Reynolds, Ortengren, Richards & de Wit (2006) labelled these two components “impulsive disinhibition” and “impulsive decision-making”. Generally, higher levels of impulsivity have been positively associated with various socially deviant behaviours such as aggression (Ramadan & McMurran, 2005), substance abuse (Dick et al., 2010) and, in particular, alcohol consumption (Grau & Ortet, 2005; Murphy & MacKillop, 2012). Several studies have indicated that impulsivity is a predictor of alcohol use disorders (Tarter & Kirisci, 1997; Clark, Vanyukov & Cornelius, 2002). Whiteside & Lynam (2001) argue that no single personality trait is sufficient to predict the tendency to act and behave impulsively. Depue & Collins (1999) support the view of impulsivity as a heterogeneous construct consisting of a cluster of lower-order traits, including sensation seeking, risk-taking, boldness, adventurism, boredom susceptibility, unreliability, and unorderliness. However, more recent research has suggested five traits of impulsivity (Cyders & Smith, 2007). Two of these are emotion based, namely positive urgency, which refers to the tendency to act rashly while in a positive mood and negative urgency, which is the tendency to act rashly while in a negative mood. Two are presumed to be due to a deficit in conscientiousness, namely lack of planning and lack of perseverance, which is the inability to maintain concentration due to

Student Psychology Journal, Volume IV BLACKWELL & BURKE

distraction or boredom. The final trait of impulsiveness, according to Cyders & Smith (2007), is sensation seeking. These five traits, however, display only a moderate positive median intercorrelation with each other of 0.25 (Cyders & Smith, 2007). This differentiation between the five traits of impulsiveness has nonetheless proven useful in understanding problematic alcohol consumption, as the urgency traits appear to predict problem drinking, whereas sensation seeking predicts the frequency of drinking (Dick et al., 2010). Moffitt, Caspi, Rutter, & Silva (2001) reveal that there is a significant gender difference in impulsivity, with males experiencing increased levels of negative emotionality and lower levels of self-restraint than females, regardless of age. It has been suggested that this gender difference in impulsivity is due to a developmental delay of cognitive and motor skill among males, resulting in a lower threshold for the capacity of delayed gratification (Bruce, Thernlund & Nettelbladt, 2006; as cited in Chapple & Johnson, 2007; Herba, Tranah, Rubia, & Yule, 2006; as cited in Chapple & Johnson, 2007). Chapple & Johnson (2007), however, uncovered two specific predictors of impulsivity for delinquents, namely maternal attachment and positive discipline, suggesting that gender differences in delinquentsâ&#x20AC;&#x2122; levels of impulsivity can be attributed to the increased adverse effect that a poor family environment appears to have on males over females.

However, the focus of literature on the impulsivity profile of offenders reduces the generalisibilty of such findings on gender effect. Keyes, Grant & Hasain (2008) reveal from an American sample that gender effects in levels of alcohol abuse have decreased in birth cohorts in more recent generations, indicating no difference in susceptibility towards alcohol abuse across gender. Grano, Virtanen, Vahtera, Elovainio & Kivimaki (2004) revealed that higher impulsivity predicted increased likelihood of becoming a heavy drinker in both genders. However, there appears to be a gender difference on other risk-taking behaviours mediated by different impulsivity traits, specifically sensation seeking (Zuckerman & Kuhlman, 2000). Risk behaviours, such as smoking, show a clear gender imbalance associated with impulsivity (Grano et al., 2004). High levels of impulsivity were revealed to predict an increased number of cigarettes smoked per day for women, but not for men (Grano et al., 2004). However, Stoltenberg, Batien & Birgenheir (2008) claimed that from a sample of 197 college age individuals, higher levels of motor impulsivity accounted for a significant amount of gender difference in risk for alcohol problems, as measured by the Barratt Impulsiveness Scale-11 (Patton, Stanford & Barratt, 1995). However, contrary to this, lower levels of impulsiv-

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. ity were also found to be associated with greater risk for alcohol consumption problems in both genders, but with a stronger association for men than women, using the Stop Signal Reaction Time. Stoltenberg et al. (2008) claim that these inconsistent findings may be due to heavy alcohol consumption as a coping mechanism for the negative affect associated with behavioural over-control. Scott Acton (2003) claims that impulsivity is a temperamental vulnerability factor for substance abuse disorders. Longitudinal studies indicate that traits can differ greatly across a lifespan (e.g. Roberts, Walton & Viechtbauer, 2006). These account for the developmental aspect of problem alcohol use patterns, as Littlefield, Sher & Wood (2009) have revealed that drinking problems tend to decrease with maturity, in line with fluctuations of impulsivity. This apparent decrease in the level of impulsivity may be due in part to the findings that reveal that the construct of impulsivity becomes more differentiated with age, resulting in the influence of more lower-order traits on impulsive behaviour with age (Leshem & Glicksohn, 2007). Factor analysis found two impulsivity factors in the age group 14-16 years, namely general impulsivity, which is characterised by trait impulsivity and preservative errors in executive functioning and cognitive impulsivity, characterised by visual-motor scanning abilities, attention functions and flexibility of cognitive sets. Three factors

were identified in the age group 20-22 years, which were general impulsivity and cognitive impulsivity, which in itself splits into two factors, that of the younger group as well as errors on The Porteus Maze task (Porteus, 1973) and time spent on the Circle Tracing task (Bachorowski & Newman, 1985). Longitudinal studies reveal a decrease in the intensity and frequency of alcohol consumption with age, suggesting the possible effect of a maturational process (Kandel & Logan, 1984). Similarly, Labouvie (1990) examined 458 young adults for 6 years between the ages of 18 and 24 years, with levels of alcohol consumption peaking at 21 years and decreasing subsequently. These findings are consistent with suggestions by McCrae & Costa Jr. (1994) that personality traits develop with age, reaching mean level at the age of 30 years, with both genders showing decreased levels of thrill-seeking behaviour. Whether impulsivity actually enhances susceptibility to alcohol dependence, or whether it is a manifestation of the same disposition that predicts alcohol use problems (Dick et al., 2010) is yet to be determined. Krueger et al. (2002) described this as the externalizing spectrum, with alcohol use reflecting one manifestation of this spectrum. The possibility of a reverse predictive or bi-directional relationship, in that health-risk behaviours may predict increasing impulsiveness, must also be considered (Grano et al., 2004). Koob &

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LeMoal (1997) revealed that heavy chronic alcohol consumption can lead to homeostatic dysregulation that induces negative affect and weakens self-regulation. Dick et al. (2010) claim that not only can alcohol increase impulsive behaviour, but it can also act chronically to increase the likelihood of impulsivity via the adaptive burden of allostasis. The multifaceted definition of impulsivity limits the interpretation of findings as it is difficult to determine what specific aspect of impulsivity is under assessment (Leshem & Glicksohn, 2007). Reynolds et al. (2006) reveal that while self-report measures of impulsivity correlate highly amongst themselves, they do not correlate strongly with behavioural tasks assessing aspects of impulsive behaviour. This appears to indicate a failure of behavioural tasks to assess the same constructs as the self-report measures. Reynolds et al. (2006) also claim that a low correlation amongst behavioural tasks implies that these measures assess different traits of impulsive behaviour. Dougherty, Mathias & Marsh (2003) argue that such discrepancies may be attributed to the differentiation between the Barratt Impulsiveness Scale-11â&#x20AC;&#x2122;s (Patton et al., 1995) assessment of personality traits exhibited over time and behavioural assessments measure state-dependent aspects of impulsivity. However, other studies have implicated various personality traits as predic-

tors of later alcohol dependence. Caspi et al. (1997) revealed from a longitudinal study on adolescents and young adults that alienation appeared to be related to drinking and violent behaviour, while stress was related to alcohol use behaviour only. This profile is supported by previous longitudinal research on men who later became alcoholics (Loper, Kammeier & Hoffman, 1973). Individuals engaging in treatment for alcohol dependence typically display high levels of neuroticism and anxiety on commencement of treatment (Zuckerman & Kuhlman, 2000). However, some researchers hypothesise that this association is a reverse relationship, in that the anxiety and depression results from the stress experienced as a consequence of the alcohol dependence. Conversely, other studies display a strong predictability of sensation seeking personality for alcohol dependence, with a very low correlation with anxiety or neuroticism (Ratliff & Burkhart, 1984, Forsyth & Hundleby, 1987). Thereby, the present study explores the relationship between self-reported levels of alcohol consumption and impulsivity. Self-report measures are utilised due to a consensus that such measures represent impulsivity as a relatively stable trait (Dougherty et al., 2003) enabling an exploration of the possible effects of age. This is in contrast to behavioural measures which are believed to represent state-dependent variations in impulsivity (Dougherty et al., 2003), under which a comparison of age

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. groups would be less meaningful. While the UPPS (Urgency, Premeditation, Perseverance & Sensation-seeking) Impulsive Behaviour Scale (Whiteside & Lynam, 2001) is also a widely used self-report measure of impulsivity, the BIS-11 (Patton et al., 1995) was chosen due to the specific dimensions of impulsivity which it categorises, namely motor impulsivity. While sensation seeking has been indicated as a predictor of the frequency of alcohol consumption (Dick et al., 2010), research into the role of motor impulsivity on gender differences in the behaviour is lacking (Bruce et al., 20006; as cited in Chapple & Johnson, 2007), facilitating the secondary aim of the study, in determining whether demographic variables such as age and gender influence this relationship between alcohol consumption and impulsivity. Methodology Research Design. This study was a quantitative on-line survey using two standardised scales, the Barratt Impulsiveness Scale-11 (Patton et al, 1995) and the Alcohol Use Disorders Identification Test (Barbor, Higgins-Biddle, Saunders & Monteiro, 2001). The design was an independent group design exploring the relationship between impulsiveness and alcohol use, as well as the effect of the variables of age and gender. The study was approved by the UCD School of Psychology Undergraduate Research Ethics Committee (UREC-SPsy).

Participants. One hundred and fifty six (156) adults with an age range of 1859 years ( =22.62 years; SD=6.73 years; M:F=1:1.62) were recruited from across the UCD student population, on a volunteer basis. Participants were categorised as either within the young age group (18-20 years) consisting of 32 males and 39 females or the older age group (21-59 years) consisting of 28 males and 56 females. Justification for these age categories derive from Leshem & Glicksohn’s (2007) findings which indicate that the 20-22 years of age category is a distinct grouping divergent from a younger group (14-16 years) by differences in cognitive impulsivity. Labouvie (1990) provides further evidence that age effects related to the relationship between impulsivity and alcohol consumption, present in the early twenties, specifically between 18-24 years, with maximum alcohol consumption peaking at 21 years.The inclusion criteria required all participants to be currently studying in UCD. Participants were informed of the risk involved as participants may have considered the information gathered to be sensitive in nature, for which service contact details were provided. Materials/ Apparatus •Qualtrics (Qualtrics Labs Inc., Provo, UT). •Two standardised scales; the Barratt Impulsiveness Scale-11 (BIS-11; Patton et al., 1995) and the Alcohol Use Disorders Identification Scale (AUDIT; Barbor et al., 2001).

Student Psychology Journal, Volume IV BLACKWELL & BURKE

Barratt Impulsiveness Scale-11 (Patton et al., 1995). This 30 item self-report Likert scale assessed the personality construct of impulsivity. The scale required participants to mark one of four responses that best represented their view on each of the statements. These statements represent three second-order factors of impulsiveness, namely attentional, motor and non-planning impulsivity. Answers ranged from ‘rarely/never’ (score of 1), ‘occasional’ (score 2), ‘often’ (score 3), and ‘almost always/always’ (score 4). On the scale as a whole, a score of between 52 and 71 is within normal limits of impulsiveness, a score of 72 or greater indicates a high level of impulsiveness and a score lower than 52 represents an over-controlled individual. The BIS-11 was further chosen for this study due to the instrument’s sensitivity to distinctions within substance use disorders (Stanford et al., 2009). Stanford et al. (2009) claim that the BIS-11 should be viewed as the point of reference for research into impulsivity due to the scale’s convergent validity and reliability of 0.83 for total scores. Alcohol Use Disorders Identification Test (Barbor et al., 2001). This is a 10 item self-report Likert scale that measured the pattern of problematic alcohol use. Participants were required to mark one of four responses for each of the statements, which best represented their experience. Scores ranged from 0-4. An overall score of 8 or more is indicative of possi-

ble hazardous drinking, harmful drinking, and/or alcohol dependence. Specifically, a score of 8-15 indicates a medium alcohol problem, while 16+ is indicative of a high level of problematic alcohol use. The AUDIT was chosen as the measure of alcohol consumption as Fleming, Barry & MacDonald (1991) demonstrated, on a college sample, that the AUDIT appears to have important advantages over other alcohol screening instruments, such as the CAGE (Cut, Annoyed, Guilty, Eye-opener) and the MAST (Michigan Alcohol Screening Test). Similarly, O’Hare & Sherrer (1999) claim that the AUDIT (Babor et al., 2001) is a valid and reliable screening device with college students. Reinert & Allen (2002) determined that the AUDIT (Babor et al., 2001) is a highly sensitive measure for criteria of current hazardous alcohol use and lifetime alcohol dependence, with internal consistency of 0.8. Procedure. Participants were provided with a link directing them to the on-line survey. The study required them to read an information sheet and confirm their consent, prior to gaining access to the scales. Demographic information on age and gender was elicited first, followed by administration of the BIS-11 and then the AUDIT. See Appendix A-D for a copy of the information sheet and the questionnaire.

Approaches to Statistical Analysis.

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. As a precursor to data analysis by means of whole and ranged between .78 and .87 a range of inferential statistics, reliability for subgroups. Thus, based on these data, of both the AUDIT and the BIS-11 scales, the AUDIT can be considered reliable alwithin the context of an Irish university though reliability is reduced somewhat for sample, was determined in order to estab- younger males (18-21 years) to .78 . lish the suitability of these measures in an Irish student sample. These data (AUDIT According to Stanford et al. (2009), and BIS-11) were then subjected to a range the BIS-11 has good internal consistency, of inferential analyses using SPSS. with a reported Cronbach alpha coefficient of 0.83. In the current study, Cronbachâ&#x20AC;&#x2122;s Two-way between groups analyses alpha was 0.85 for the sample as a whole of variance were performed to explore and ranged between .76 and .87 for subwhether there was an impact of gender groups, with a reduction in reliability for (k=2) and age (k=2; 18-20 year olds and younger males (.76). 21 year olds and over) on the reported total alcohol use and total impulsivity Taken together, reliability analyses scores. Two-way between-groups anal- of both the AUDIT and BIS-11 data, for yses of variance were also employed to the sample as a whole and for the age and examine the effects of age and gender on gender subgroups, revealed that, for both the individual dimensions of impulsivi- scales, alpha coefficients were within the ty (attentional, motor and non-planning). acceptable range for reliability (i.e. >.7). Chi-squared analyses were performed in However, reliability decreased somewhat order to determine whether categorisa- on both scales for males in the category of tion of alcohol use (low, medium or high 18-20 years. problem) was dependent upon age or gender. Pearson product-moment correlations Table 1 below presents summary data were computed to determine the strength for the AUDIT. Raw scores are presented, and direction of possible linear relation- together with data relating to the score disships between impulsiveness and alcohol tribution for the total sample and also for use (raw score). each of the age and gender subgroups. Results Reinert & Allen (2002) reported an internal consistency on AUDIT of 0.8. In the current study, the Cronbach alpha coefficient was 0.83 for the sample as a

Student Psychology Journal, Volume IV BLACKWELL & BURKE

Table 1: Summary data for the AUDIT.

Inspection of this table reveals that, across the sample as a whole, the mean score on AUDIT fell within the medium range of alcohol problems ( =9.91, SD=4.83). Mean scores were also within the medium range of alcohol problems for males in both age groups (18-20 years: = 9.75, SD= 4.36; 21 and over: =9.56,

SD=5.35) and for females in both age groups (18-20 years: =10.49; SD=5.18; =9.76, SD=4.67). Table 2 presents summary data for a 2-way ANOVA, examining the impact of age and gender on AUDIT total scores.

Table 2: ANOVA summary table for AUDIT

In terms of total raw scores for alcohol use problem rating, no statistically significant interaction was observed between age and gender, F(1, 149)= .106, p=.746. There was also no statistical significant main effect of age group, F(1, 149)= .318, p=.574 or gender, F(1, 149)= .337, p=.562. Based on these findings, it would appear

that alcohol use problem rating, as determined by means of AUDIT raw scores, did not differ as a function of either age category or gender. For the total sample, the percentages of participants scoring in the low, medium and high problem category of alcohol

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. consumption were 34.6%, 50.3% and 15.0% respectively (see Table 3). For these categorical data, chi-squared analyses did not reveal any evidence that alcohol use depended on gender in either the younger or older age groups [18-20 years: chi-squared=2.08, df=2, p=.354; 21 and over: chi-squared=4.496, df=2, p=.106]. Inspection of the data reveals that within each age group, a significant minority of both males and females obtained scores that fell within the ‘high’ problem category. Within the male subgroup, chisquared analysis did not reveal any ev-

idence that alcohol use depended on age [chi-squared=0.73, df=2, p=.693). In contrast, chi-squared analysis revealed that, for females, alcohol use did depend on age (chi-squared=9.43, df=2, p=.009]. Inspection of the data indicate that the majority of females categorised as ‘high’ in terms of level of alcohol use problem fall within the younger age group (10/14). Table 3 below presents summary data for the BIS-11. In this table, raw scores are presented, together with data relating to the score distribution for the total sample and also for each of the age and gender subgroups.

Table 3: Summary data for the BIS-11

Inspection of this table reveals that, across the sample as a whole, the mean score on BIS-11 fell within the normal range of impulsiveness ( =64.34, SD=10.95). The mean BIS-11 score also fell within the normal range for males

within both age categories (18-20 years: =66.44, SD=9.02; 21 and over: =61.75, SD=10.87) and for females within both age categories (18-20 years: =65.5, SD= 11.45; 21 and over: = 63.642, SD=11.58).

Student Psychology Journal, Volume IV BLACKWELL & BURKE

Table 4: ANOVA summary table for BIS-11

Inspection of this table reveals no evidence of a significant interaction between age and gender on total impulsivity scores, F(1,150)=.603, p=.439. There was also no statistically significant main effect for age, F(1,150)=3.224, p=.075 or gender, F(1,150)=.069, p=.794. It can, therefore, be inferred from this that total scores on impulsivity did not differ as a function of age category or gender. This finding was confirmed by results of chi-squared analyses. Chi-squared analyses did not reveal any evidence that impulsivity depended on age in either the male or female subgroups [males: chi-squared=4.02, df=2, p=.13; females: chi-squared=3.28, df=2, p=.19]. Similarly, chi-squared analyses did not reveal any evidence that impulsivity depended on gender in either the younger or older age groups [18-20 years: chisquared=0.73, df=2, p=.69; 21 and over:

chi-squared=0.04, df=2, p=.98]. Inspection of the data reveals that in the total sample, the majority of participants (62.8%) obtained scores that placed them within the normal range of impulsivity. 24.4% scored within the highly impulsive range whilst the remainder (11.5%) fell within the overcontrolled range. Inspection of the data also reveals a broadly similar pattern of scores for both males and females across both age groups. Additional analysis was then performed in order to explore potential age and gender differences on impulsivity dimensions. Table 5 presents the summary data for the 2-way ANOVA, examining the impact of age and gender on the attentional dimension of impulsivity.

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. Table 5: ANOVA summary table for the attentional dimension

A statistical significant disordinal interaction between age and gender was observed on the attentional dimension F(1,152)=4.185, p=.043 (see Figure 1 below). However, the effect size of this interaction is small (partial eta squared=0.27). Inspection of Figure 1 suggests that impulsivity scores decrease somewhat as a function of age for males, but not for females. This finding was confirmed by means of independent samples t-tests. Direct comparison of younger and older males revealed that scores declined significantly across the age groups [18-20 years: =18.13, SD=3.26; 21 and over: =15.50, SD=3.26; t=3.11, df=58, p=.003]. In contrast, for females, scores did not differ significantly across age groups [1820 years: =17.21, SD=4.49; 21 and over: =17.07, SD=3.44; t=0.17, df=94, p=.868]. Within the younger age group, scores for males and females did not differ significantly [male: =18.13, SD=3.26; female: =17.21, SD=4.49; t=0.97, df=69, p=.336]. However, within the older age group, males scored significantly below the level of females [male: =15.50, SD=3.26; female: =17.07, SD=3.44; t=-2.01, df=83, p=.048].

Figure 1: Interaction between age and gender on the attentional dimension. Table 6 presents the summary data for the 2-way ANOVA, examining the impact of age and gender on the motor dimension of impulsivity.

Student Psychology Journal, Volume IV BLACKWELL & BURKE

Table 6: ANOVA summary table for the motor dimension.

The interaction between age and gender on the dimension of motor impulsivity was not statistically significant, F(1,150)=.433, p=.512. There was also no statistically significant main effect for age, F(1,150)=.467, p=.495 or gender, F(1,150)=.168, p=.682. Table 7 presents the summary data for the 2-way ANOVA, examining the impact

of age and gender on the non-planning dimension of impulsivity. As with motor impulsivity, no statistically significant interaction between age and gender was observed on the non-planning dimension, F(1,152)= .177, p=.675. There was also no statistically significant main effect for either age, F(1,152)=2.731, p=.100 or gender, F(1, 152)=.080, p=.778.

Table 7: ANOVA summary table for the non-planning dimension.

Taken together, these results provide little evidence that age and gender impact on overall impulsivity or on the motor or non-planning aspects of impulsivity. In contrast, there is evidence to suggest that age and gender are of relevance when the attentional dimension of impulsivity is considered. Relationships between Alcohol Consumption and Impulsivity. A strong

positive correlation was observed between total impulsiveness scores and total scores on the AUDIT, r= .511, n=151, p <.01, with high levels of impulsivity associated with high levels of harmful alcohol use. A strong positive association was also observed between motor impulsivity and AUDIT scores, r= .506, n=151, p<.01. A moderate positive correlation was observed between the attentional trait of impulsiveness and total AUDIT scores,

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. r= .324, n=153, p <.01 and between non-planning impulsivity and AUDIT scores, r=.400, n=153, p<.01. Due to the influence of age and gender on the attentional dimension of impulsivity, as detailed above, together with the observation that high levels of problem alcohol use is associated with younger age in females, correlations between AUDIT scores and impulsivity were also computed for each age and gender subgroup separately. A summary of these analyses is presented in Table 8 below. Inspection of these data confirmed that there is a significant association between total impulsiveness and alcohol score for both males and females. Further-

more, this significant association is observed regardless of age group. However, males within the older age range (21 years and over) display the strongest correlation with total BIS-11 scores (r=.701, p<.001). Similarly, data confirms that a significant association between each of the subscales of impulsivity (attentional, motor and non-planning) and total AUDIT scores on levels of problematic alcohol use exists for both males and females, regardless of age category. Again, a pattern emerges, in which males within the older age category, display the strongest correlation between each of these subscales and total AUDIT scores (attentional, r=.649, p<.001; motor, r=.600, p<.001; non-planning, r=.595, p<.001).

Table 8 Correlation coefficients exploring the relationship between total alcohol use (AUDIT) and impulsiveness (BIS-11) for age and gender subgroups.

Student Psychology Journal, Volume IV BLACKWELL & BURKE

It can be inferred from this that males in the 21 years and over age range display a stronger positive association between impulsivity and harmful alcohol use on all three dimensions of impulsivity, as well as on total impulsivity scores, than both males in the younger age category and females, regardless of age category. It can also be observed from the data that the correlation coefficients between total impulsivity, motor and non-planning scores and total AUDIT scores remain relatively constant when determined from the sample as a whole, or from across the subgroups. The same effect, however, is not observable with regards to the attentional dimension. The strength of the correlation decreases for females, regardless of age category. This may be viewed as a consequence of the age-gender interaction on the attentional dimension, which was observable from the 2-way between group ANOVA (see Table 5 and Figure 1). â&#x20AC;&#x192; Discussion This study aimed to uncover whether there is an association between levels of impulsivity and patterns of alcohol use behaviours and whether such an association has a gender or age effect. Findings reveal that the majority of participants fell within the medium range of alcohol use problems, as measured by the AUDIT, and the majority of the total

sample fell within the normal range of impulsiveness, as measured by the BIS11, independent of age and gender. This finding is at variance with the results of past research that claimed that both an age and gender effect exists, both on patterns of alcohol consumption and on levels on impulsiveness (Littlefield et al., 2009). This could, potentially, be attributable to the relatively low total variance in alcohol scores for which impulsivity scores were accountable. As Stoltenberg et al. (2008) claim, present findings may be due to heavy alcohol consumption as a coping mechanism for the negative affect associated with behavioural over-control. The strong correlation observable between total impulsivity and problem alcohol use corroborates past research that indicated a positive association between impulsivity and substance abuse, in particular alcohol misuse (Grau & Ortet, 2005; Murphy & MacKillop, 2012). A strong association between motor impulsivity, as well as a moderate association between attentional and non-planning impulsivity and problem alcohol use is also evident from the present findings. Overall, evidence emerges that males display a stronger correlation between impulsivity (total, attention, motor and non-planning) and alcohol use across age groups. With regards to the motor dimension, this is in accordance with Stoltenberg et al. (2008), who revealed, using the

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. BIS-11, that motor impulsivity is a select dimension of the impulsivity construct that directly influences a gender effect in terms of alcohol use. This contradicts Grano et al. (2004) who revealed that higher impulsivity predicted increased likelihood of becoming a heavy drinker in both genders. However, if using an experimental measure, rather than a self-report measure, Stoltenberg et al. (2009) uncovered that while both genders displayed an association between alcohol use and impulsivity, this correlation was stronger for males than females. This finding is reflected in the current study. Grano et al. (2004), however, claimed that while a gender effect is evident on impulsivity, in relation to risk-taking behaviours, such as cigarette smoking or sexual deviance, no such effect is evident for alcohol use as a specific form of risk taking behaviour. Discussing alcohol levels separately from impulsiveness, further inspection revealed that a significant minority of males and females in both age categories fell within the high range of problematic alcohol use. This adheres to Keyes et al. (2008) who argued that there is no gender difference is susceptibility to alcohol abuse disorders, independent of impulsivity. Littlefield et al. (2009) also claimed that the prevalence of problematic levels of alcohol consumption decreases with age, in line with maturity. However, reported harmful alcohol use for females was dependent on age, with the majori-

ty of females categorised as having high levels of problematic alcohol use being within the younger age range. The failure of the present study to reveal an age effect for males on alcohol use may be due to the reduced reliability of the AUDIT for the younger males within the current sample due to the insufficient age difference between the two age cohorts for the impact of increased age to be revealed. Referring to total levels of reported impulsiveness, the current study revealed no age or gender bias in impulsiveness. This contradicts findings of Moffitt et al. (2001) and Chapple & Johnson (2007), which claimed that males experienced more impulsiveness than females, regardless of age. However, the generalisability of the latterâ&#x20AC;&#x2122;s findings is questionable considering the delinquent nature of the sample. The present study also contradicts findings revealing an age effect on levels of impulsiveness due to a differentiation of the construct of impulsivity across the lifespan, resulting in the influence of more lower-order traits reducing impulsive behaviour with age (Leshem & Glicksohn, 2007). Considering impulsivity as a complex construct, encompassing various dimensions, attentional, motor and non-planning impulsivity were also investigated. Similar to total reported impulsivity, findings reveal no age, gender or age and gender interaction on motor or non-planning impu-

Student Psychology Journal, Volume IV BLACKWELL & BURKE

lsivity. However, attentional impulsivity provides evidence that while no independent age or gender effect on this dimension is observable; a significant age and gender interaction emerges. This interaction provides evidence that attentional impulsivity does not differ across genders for the younger age category, but declines significantly with age for males, but not for females. Evidence of such a finding is not apparent in former research. Various aspects of the current findings both corroborate and contest former research, therefore, the current methodological limitations must be considered. As noted, the majority of research into the age effect on impulsivity and alcohol use has reached a general consensus that both reduce in line with age (Scott-Acton, 2003; Littlefield et al., 2009; Leshem & Glicksohn, 2007). Restrictions of the sample limited the age range obtainable within a university setting. Consequentially, the age categories elicited may not reflect the age effect that is evident in the studies of Labouvie (1990) and McCrae & Costa Jr. (1994). Labouvie (1990) determined that alcohol consumption peaks at 21 years, decreasing subsequently. The incorporation of 21 years within the older category within the present study may have increased the older categories reported impulsiveness and alcohol use, reducing significance between the groups. Similarly, McCrae & Costa Jr. (1999) outline that mean consumption occurs at age 30,

which may have caused a distorted differentiation of effect between age groups in the current study. As well as the limitations in regards to the age range, potential confounding variables, such as substance abuse as a consequence of externalising problems, could be controlled for in future research. Kruegar et al. (2002) referred to this as an externalising spectrum, in which both impulsivity and alcohol abuse may be a behavioural manifestation of a third, unknown variable such as current stress levels. A further feature of the study that could be altered is the inclusion of a more differentiated definition of impulsivity along further dimensions outside of those addressed by the BIS-11. Various studies have indicated a high correlation between the sensation-seeking trait of impulsivity and alcohol dependence (Ratliff & Burkhart, 1984, Forsyth & Hundleby, 1987). However, the BIS-11 fails to isolate sensation-seeking as a distinct dimension. A more comprehensive knowledge of impulsivity as a complex construct would be obtained by incorporating other reliable measures of impulsivity into the study, such as the UPPS (urgency, premeditation, perseverance and sensation seeking; Whiteside & Lynam, 2001), the Eysenck Impulsiveness Scale (Eysenck & Eysenck, 1878), or non-psychometric measurements such as the Porteus Maze (Porteus, 1973), or the Circle Drawing Task (Bachorowski & Newman, 1985).

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. The results of current study suggest some practical implications for future research and policy measures in the area of alcohol misuse in an Irish context. The current findings are indicative of a less pessimistic view of alcohol use in an Irish university setting than was initially anticipated. However, since the majority of the sample report within the medium range of problematic drinking, potential action must be considered as such behaviours may be indicative of future hazardous drinking. Age cannot be viewed as the predominant variable mediating such behaviours, as a higher proportion of the older age category report in the medium range of alcohol problems than the younger age category. However, neither can this relationship be exclusively deemed as a consequence of individual differences in personality, as confounding influences such as stress must be controlled for in future research. Potentially, a measure taken to reduce alcohol misuse, as a cultural phenomenon in Ireland, may be to implement education to elicit such coping strategies and awareness of the aversive nature of impulsiveness on risk-taking behaviours, rather than a sole emphasis on price incentives in order to reduce consumption. References Aragues, M., Jurado, R., Quinto, R., & Rubio, G. (2011). Laboratory paradigms of impulsivity and alcohol dependence: A review. European Addiction Research, 17(2), 64-71.

Bachorowski, J.A., & Newman, J.P. (1985) Impulsivity in adults: Motor inhibition and time estimation. Personality and Individual Differences, 6, 133-136. Barbor, F.T., Higgins-Biddle, J.C., Saunders, J.B., & Monteiro M.G. (2001). The Alcohol Use Disorders Identification Test: Guidelines for use in primary care (2nd Ed.). World Health Organisation. Bruce, B., Thernlund, G., & Nettlebladt, U. (2006) ADHD and language impairment: A study of the parent questionnaire FTF (Five to Fifteen). European Child Adolescent Psychiatry, 15, 52-60. Caspi, A., Begg, D., Dickson, N., Harrington, H.L., Langley, J., Moffitt, T.E., & Silva, P.A. (1997). Personality differences predict health-risk behaviours in young adulthood: evidence from a longitudinal study. Journal of Personality and Social Psychology, 73, 1052-1063. Chapple, C.L. & Johnson, K.A. (2007). Gender differences in impulsivity. Youth Violence and Juvenile Justice, 5(3), 221-234. Clark, D.B., Vanyukov, M. & Cornelius, J. (2002). Childhood antisocial behaviour and adolescent alcohol use disorders. Alcohol Research and Health, 26, 109-115.

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Cyders, M.A., & Smith, G.T. (2007). Mood-based rash action and its components: positive and negative urgency and their relations with other impulsivity-like constructs. Personality and Individual Differences, 43(4), 839-850. Depue, R.A., Collins, P.F. (1999). Neurobiology of the structure of personality: DA, facilitation of incentive motivation, and extraversion. Behavioural and Brain Sciences, 22, 491-569. Dick, D.M., Smith, G., Olausson, P., Mitchell, S.H., Leeman, R.L., Oâ&#x20AC;&#x2122;Malley, S.S., & Sher, K. (2010). Understanding the construct of impulsivity and its relationship to alcohol use disorders. Addiction Biology, 15, 217226. Dougherty, D.M., Mathias, C.W. & Marsh, D.M. (2003). Laboratory measures of impulsivity. In E.F. Coccaro (Ed.), Aggression: Psychiatric assessment and treatment. Medical psychiatric series No. 22 (pp. 247-265). New York: Marcel Dekker Publishers. Eysenck, S.B.G., & Eysencj, H.J. (1978). Impulsiveness and venturesomeness: Their Position in a dimensional system of personality description. Psychological Reports, 43(3), 1247-1255. Fleming, M.F., Barry, K.L., MacDonald, R. (1991). The Alcohol Use Disorders Identification Test (AUDIT) in a College Sample. International Journal of Addictions, 26, 1173-1185. Forsyth, G. & Hundelby, J.D. (1987). Personality and situation as determinants

of desire to drink in young adults. International Journal of the Addictions, 22, 653-669. Grano, N., Virtanen, M., Vahtera, J., Elovainio, M., & Kivimaki, M. (2004). Impulsivity as a predictor of smoking and alcohol consumption. Personality and Individual Differences, 37, 1693-1700. Grau, E., & Ortet, G. (1999). Personality traits and alcohol consumption in a sample of non-alcoholic women. Personality and Individual Differences, 27, 1057-1066. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Kandel, D.B. & Logan, J.A. (1984). Patterns of drug use from adolescence to young adulthood. I. Periods of risk for initiation, stabilization and decline in use and discontinuation. American Journal of Public Health, 74(7), 660666. Keyes, K. M., Grant, B. F., & Hasin, D. S. (2008). Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population. Drug and Alcohol Dependence, 93(1-2), 21-29. doi: http://dx.doi.org/10.1016/j.drugalcdep.2007.08.017 Koob, G.F. & LeMoal, M. (1997). Drug abuse: hedonic homeostatic dysregulation. Science, 278, 52-58.

Empirical Investigations

EFFECTS OF AGE AND GENDER ON ALCOHOL CONSUMPTION AND IMPULSIVITY. Krueger, R.F., Hicks, B.M., Patrick, C.J., Carlson, S.R., Iacono, W.G., McGue, M. (2002). Etiologic connections among substance dependence, antisocial behaviour, and personality: modelling the externalising spectrum. Journal of Abnormal Psychology, 111, 411-424. Labouvie, E.W. (1990). Personality and alcohol and marijuana use: patterns of convergence in young adulthood. The International Journal of the Addictions, 25(3), 237-252. Leshem, R & Glicksohn, J. (2007). The construct of impulsivity revisited. Personality and Individual Differences, 43(4), 681-691. Littlefield, A.K., Sher, K.J., & Wood, P.K. (2009). Is ‘maturing out’ of problematic alcohol involvement related to personality change? Journal of Abnormal Psychology, 118, 360-374. Loper, R.G., Kammeier, M.L., & Hoffman, H. (1973). MMPI characteristics of college males who later became alcoholics. Journal of Abnormal Psychology, 82, 159-162. McCrae, R.R. & Costa Jr., P.T. (1994). The stability of personality: Observations and evaluations. Current Directions in Psychological Sciences, 3(6), 173175. . Moeller, F.G., Barratt, E.S., Dougherty, D.M., Schmitz, J.M., & Swann, A.C. (2001). Psychiatric aspects of impulsivity. American Journal of Psychiatry, 158, 1783-1793.

Moffitt, T. E., Caspi, A, Rutter, M., & Silva, P. A. (2001). Sex differences in antisocial behavior: Conduct disorder, delinquency and violence in the Dunedin Longitudinal Study. Cambridge, UK: Cambridge University Press. Murphy, C. & MacKillop, J. (2012). Living in the here and now: interrelationships between impulsivity, mindfulness, and alcohol misuse. Psychopharmacology, 219(2), 527-36. O’Hare, T., & Sherrer, M.V. (1999). Validating the Alcohol Use Disorders Identification Test in college first offenders. Journal of Substance Abuse Treatment, 17, 113-119. Patton, J.H., Stanford, M.S., & Barratt, E.S. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51, 768-774. Porteus, S.D. (1973). Porteus Maze test: Fifty years’ application. Palo Alto, CA: Pacific Books. Qualtrics Labs, Inc. (2013). Provo, Utah, USA. 37,330. Ramadan, R., & McMurran, M. (2005). Alcohol and aggression: Gender differences in their relationships with impulsiveness, sensation seeking and social problem solving. Journal of Substance Use, 10(4), 215224.

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Ratliff, K.G. & Burkhart, B.R. (1984). Sex differences in motivation for and effects of drinking among college students. Journal of Studies in Alcohol, 45, 26-32. Reinert, D.F., & Allen, J.P. (2002). The Alcohol Use Disorders Identification Test (AUDIT): A review of recent research. Alcoholism: Clinical and Experimental Research, 26(2), 272-279. Reynolds, B., Ortengren, A., Richards, J.B., & de Wit, H. (2006). Dimensions of impulsive behaviour: Personality and behavioural measures. Personality and Individual differences, 40(2), 305-315. Roberts, B.W., Walton, K.E. & Viechtbauer, W. (2006). Patterns of mean-level change in personality traits across the life course: a meta-analysis of longitudinal studies. Psychological Bulletin, 1(32), 1-25. Scott Acton, G. (2003). Measurement of impulsivity in a hierarchical model of personality traits: Implications for substance use. Substance Use and Misuse, 38(1), 67-83. Stoltenberg, S.F., Batien, B.D., & Birgenheir, D.G. (2008). Does gender moderate associations among impulsivity and health-risk behaviors. Addictive Behaviors, 33(2), 252-265. Stanford, M.S., Mathias, C.W., Dougherty, D.M., Lake, S.L., Anderson, N.E., & Patton, J.H. (2009). Fifty years of the Barratt Impulsiveness Scale: An update and review. Personality and Individual Differences, 47, 385-395.

Tarter, R., & Kirisci, L. (1997). Multivariate typology of adolescents with alcohol use disorder. American Journal on Addictions, 6, 150-158. Whiteside, S.P., & Lynam, D.R. (2001). The five factor model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689. Zuckerman, M. & Kuhlman, D.M. (2000). Personality and Risk-Taking: Common Biosocial Factors. Journal of Personality, 68(6), 999-1029.

Student Psychology Journal, 2013, 41-52

A Comparison of Twin and Non-Twin Siblings’ Use of Relational Maintenance Behaviours and Associate Measures of Sibling Liking Patrice Brennan & David Gogan Dublin City University Correspondence: patricebyrnebrennan@gmail.com

abstract

The present study examined (1) whether twin siblings used relational maintenance behaviours at a higher rate than nontwin siblings and (2) whether twins indicated that they liked their twin siblings more than non-twin siblings. 99 twins and 93 non-twins were recruited via social media and university mailing lists. Relational maintenance behaviours were measured using Canary and Stafford’s (1992) Relational Maintenance Behaviour Scale and Liking was measured using Rubin’s (1970) Liking Scale. Results indicated that (i) twin siblings used openness, assurances, and networks relational maintenance behaviours at a significantly higher rate than non-twin siblings; (ii) twin siblings indicated that they liked each other more than non-twin siblings. Further research should consider analysing opposite-sex siblings which may provide different perspectives and a richer analysis of sibling relationships. Literature Overview Introduction. Sibling relationships are the longest relationships that many individuals will experience in their lifetime and, as such, have powerful positive and negative influences across the lifespan (Cicirelli, 1995; Ponzetti, & James, 1997). Positive outcomes, include prosocial behaviour (Whiteman, McHale,

& Crouter, 2007) empathy (Tucker, Updegraff, McHale, & Crouter, 1999) companionship, mutual aid, comfort and friendship (Goetting, 1986), emotional support (Lee, Mancini & Maxwell, 1990) and intimacy (Fowler, 2009). Moreover, it is posited that twin sibling relationships are closer and more intense than non-twin sibling relationships (Klein, 2003; Neyer, 2002; Penninkilampi-Kerola, Moilanen &

Student Psychology Journal, Volume IV BRENNAN & GOGAN

Kaprio, 2005; Segal, 1993). From a negative perspective, elevated sibling conflict in adolescence is associated with peer difficulties and antisocial behaviours (Bank, Burraston & Snyder, 2004) Sibling Relationships. Despite the involuntary nature of the sibling relationship, individuals continue to maintain strong ties with their siblings throughout the lifespan even as the dynamics of the relationship change depending on life circumstance (Van Volkom, 2008). For example, siblings may be drawn closer by life event such as the birth of a child or death of a parent (Van Volkom, 2008). Myers (2011) identified two overarching reasons for why adult siblings maintain their sibling relationships: circumstance (e.g. they are family, residential proximity) or choice (e.g. provision of support for each other, sharing of similar or common interests and experiences, friendship and love). Myers (2011) found that genetic ties were the primary reason adults maintained their sibling relationships. Twin Sibling Relationships. The twin sibling relationship is distinctive in that twins are a constant companion for each other throughout the lifespan from birth (Neyer, 2002; Nozaki, Fujisawa, Ando & Hasegawa, 2012). The twin relationship is also more reciprocal and equitable in nature than the relationship between non-twin siblings due to age sim-

ilarity, genetic relatedness, and the amount of time twin siblings spend together growing up (Nozaki et al., 2012). Identical twin siblings share 100% of their genes, whereas non-identical twins share only 50% Correlation in personality between identical twins was found to be twice as high as that of non-identical twins and non-twin siblings (Loehlin, 1989, Segal, 2013). The concepts of ‘attachment’ (Bowlby, 1969, cited in Tancredy, & Fraley, 2006) and “inclusive fitness’ (Hamilton, 1964), have been employed when describing the relationship between twin siblings. From an attachment theory perspective, being a twin as opposed to not being a twin is associated with the extent to which a person uses his or her sibling as an attachment figure (Tancredy, & Fraley, 2006). Tancredy and Fraley’s (2006) study assessed the presence of attachment features and function in twin relationships and examined whether twins were more likely than non-twin siblings to use their siblings as attachment figures. They posited that both identical and fraternal twins are more likely to use one another as attachment figures than non-twin siblings because of unique developmental circumstances, for example, spending extended periods of time together, sharing common experiences and environments, and having one another available as sources of care and comfort during stressful times. Indeed, from an evolutionary-based

Empirical Investigations

TWIN AND NON-TWIN USE OF RELATIONAL MAINTENANCE BEHAVIOURS AND MEASURES OF SIBLING LIKING perspective, it is argued that siblings who share a greater proportion of genes (e.g., identical twins) are more likely than other siblings (e.g., fraternal twins and non-twin siblings) to be closer to one another (Hamilton, 1964; Neyer & Lang, 2003). Moreover, according to recent evolutionary psychological research, Lewis (2011) found that within families, individuals reported greater closeness and altruism toward siblings who more closely resembled them, suggesting that kin recognition influences sibling relationship quality. Fraley and Tancredy’s (2012) research on sibling relationships found that both attachment and inclusive fitness perspectives were necessary for explaining the nature of sibling relationships. For example, Fraley and Tancredy’s (2012) study found that twins were more likely to be attached (i.e., more likely to use one another as targets of proximity seeking, as a safe havens during times of stress, and as a secure base) than non-twins (attachment perspective), but that identical twins were more likely than non-identical twins to be attached to one another (inclusive fitness perspective), indicating that these two perspectives are not mutually exclusive in explaining the twin bond. As such, the type of sibling relationship to which an individual belongs may influence the use of relational maintenance behaviours (Mikkelson et al., 2011). Relational Maintenance Behaviours. Relational maintenance behaviours are particular kinds of interac-

tions and ways of communicating that people use to preserve ongoing relationships, and without which relationships are prone to deterioration (Carney & Stafford, 1992). While the concept was originally applied to romantic relationships, Myers et al. (2001) used the concept to examine sibling relationships. The five approaches identified by Carney and Stafford (1992) are: positivity – interacting with a partner in a cheerful, optimistic and uncritical manner; openness – discussing the nature and desires for the relationship; assurances – indicating a desire to remain involved in and committed to the relationship; networks – common affiliations to which both parties belong; sharing tasks – both partners participating in and sharing responsibility for tasks unique to the relationship. However, little research has examined the extent to which the use of relational maintenance behaviours differs amongst twin siblings and non-twin siblings. One study examined the differential use of relational maintenance behaviours amongst genetically related and genetically unrelated siblings (e.g. adopted and step-siblings) and found significant differences in the use of such behaviours between the sibling types (Mikkelson et al., 2011). Therefore, this study will attempt to address the gap in the literature by comparing a sample of twin siblings and non-twin siblings on their use of relationship maintenance behaviours.

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Liking and Sibling Relationships. Liking refers to the degree of favourable evaluation and respect directed toward another individual (Rubin, 1970). Additionally, Rubin (1973, cited in Canary, Stafford, & Semic, 2002) posited that liking was based on, amongst other things, perceived similarity. Tenney, Turkheimer and Oltmanns, (2009) found that greater personality similarity between pairs of peers was associated with mutual and increased liking. These authors suggested that people are drawn to others who exhibit the same pattern of personality traits because they automatically like whatever reminds them of themselves. Consistent with this assumption, the current study will seek to examine whether there is a significant difference in liking between twin siblings and non-twin siblings. The Present Study. The present study tested two hypotheses: (1) that there will be a significant negative difference in the use of positivity, openness, assurances, networks, and sharing tasks relational maintenance behaviours between twin siblings and non-twin siblings; and (2) that twins will indicate that they like their twin siblings significantly more than non-twins like their siblings. Methodology Design. The study used a cross-sectional, between-groups design. Participants. 99 twins (M age = 35.76

years, SD = 11.61 years) and 93 non-twins (M age = 37.59 years, SD = 9.71 years) took part. Of the twin group, 66 (66.7%) indicated that they were an identical twin, and 33 (33.3%) indicated that they were a non-identical twin. Gender distribution showed participants were 54 (28%) males and 138 (72%) females. Response rate. The webpage hosting the measures was accessed 386 times and 195 individuals submitted responses. Three participant’s responses were discarded as they did not indicate their sibling type. In total, 192 questionnaires were completed giving a response rate of 49.74%. Measures. Participants completed a short questionnaire capturing demographic variables (i.e. participant and sibling sex, age, nationality, type of sibling relationship). Relational maintenance behaviours were measured by the Relational Maintenance Behaviour Scale (RMB) (Canary & Stafford, 1992). This is a 29-item scale which captures respondents’ use of each of five relational maintenance behaviours: positivity, openness, assurances, networks, and sharing tasks. For the present study, the instructions indicated that participants should respond in respect of sibling relationships. The internal reliability was acceptable: Positivity (α =.90), Openness (α =.92), Assurance (α = .82), Networks (α =.88), Sharing Tasks (α =.86). Liking was measured by Rubin’s (1970) Liking Scale.

Empirical Investigations

TWIN AND NON-TWIN USE OF RELATIONAL MAINTENANCE BEHAVIOURS AND MEASURES OF SIBLING LIKING This is a 13-item scale that asks respondents to indicate their general feelings of liking towards a targeted partner. In this study participants were asked to indicate their general feelings of liking in relation to a same-sex sibling or same-sex twin. Cronbachâ&#x20AC;&#x2122;s alpha was .95. Consistent with similar studies on sibling relationship (e.g. Fowler, 2009; Neyer, 2002; Neyer & Lang, 2003) and in an attempt to keep the population homogeneous, non-twin siblings and non-identical twin siblings were instructed to report on a same-sex sibling. Procedure. Ethical approval was applied for and granted by Dublin City University Ethics Committee. The measures were hosted on the website surveymonkey. Links to the website were circulated on Facebook, college email, and other social media sites. A number of organisations specifically for twins circulated the link to their members to specifically access twin participants. Participants were instructed to respond in reference to one particular same-sex sibling, with the non-twin participants directed to respond in reference to a same-sex sibling not more than four years older or younger than themselves. All identical twin siblings were instructed to respond in reference to their identical twin sibling; all non-identical twin siblings were instructed to respond in reference to their relationships with their same-sex non-identical twin sibling; and all nontwin siblings were instructed to respond in reference to their relationship with their

same-sex non-twin sibling. Data analysis. While the scores for some of the scales were not normally distributed (positivity, sharing tasks), parametric tests were used as they are robust in the face of violations of normality (Rasch & Guiard, 2004). Independent t-tests were used to examine differences between groups. With regard to maintenance behaviours, a Bonferroni correction was used because multiple comparisons were being made, resulting in the level for significance being set at p < .01. Results Descriptive Statistics. The means and standard deviation of all measures for the twin and non-twin groups are outlined in Table 1 below:

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Table 1: Mean (M) and standard deviation (SD) measurement scores for twin and nontwin groups.

Hypothesis testing. Relational maintenance behaviours. As can be seen from Table 1, the groups significantly differed on assurances, openness and network relational maintenance behaviours. This suggests that twin siblings use these behaviours more frequently than non-twin siblings. There was no significant difference between the two groups on the use of positivity and sharing tasks relational maintenance behaviours Liking. Table 1 also indicates that a significant difference was found between twin siblings and non-twin siblings on liking. This would suggest that twin siblings tended to like each other more than nontwin siblings did. Discussion

The primary purpose of this study was to investigate whether there was a significant difference in the reported use of relational maintenance behaviours between twin siblings and non-twin sibling, with a further focus on measures of sibling liking. A key finding of the study was that twin siblings reported a significant difference in their use of openness, assurances, and networks relational maintenance behaviours compared to non-twin siblings. No significant difference in the use of positivity, and tasks were reported between the two groups. In addition, twin siblings tended to like each other more than non-twin siblings. Hypothesis One Discussion.Hypothesis 1, which stated there would be significant differences in the use of openness,

Empirical Investigations

TWIN AND NON-TWIN USE OF RELATIONAL MAINTENANCE BEHAVIOURS AND MEASURES OF SIBLING LIKING assurances, and networks relational maintenance behaviours between twin siblings and non-twin siblings was supported. This supports Mikkelson et al.’s (2011) assertion that these three behaviours were primarily concerned with discussing the nature of the sibling relationship (openness); messages that stress one’s continuation of the relationship (assurances); and interacting with common friends and relatives (networks). Moreover, it is suggested that these behaviours are associated with an equitable relationship (Canary & Stafford, 1992) and, as twin siblings’ are reported to have a more equitable relationships (Nozaki, Fujisawa, Ando, & Hasegawa, 2012), openness, assurances and networks behaviours would be expected to be used more frequently by twin siblings than nontwin sibling. This study’s findings also support the notion that a long history of shared interactions may influence twin siblings’ communication strategies (Neyer, 2002, Nozaki et. al., 2012). Furthermore, twins are more prone to use one another as attachment figures than non-twins because of shared life experiences (Bowlby, 1969; Tancredy & Fraley, 2006). Moreover, from an evolutionary-based perspective (Hamilton, 1964), it was posited that twin siblings (and in particular identical twin siblings who share a greater proportion of genes) are closer to one another, because through gene similarity, twins can increase their evolutionary success by promoting the re-

production and survival of their twin. The hypothesis that there would be a significant difference between twin siblings and non-twin siblings in their use of positivity and sharing tasks relational maintenance behaviours was not supported. Although inconsistent with previous research (e.g. Mikkelson et al., 2011), what this study’s findings suggest is that regardless of the type of sibling relationship (i.e. twin or non-twin), positivity (interaction with a sibling in a cheerful, optimistic and uncritical manner) and sharing tasks (performing one’s responsibilities in the relationship) may be fundamental behaviours common to all siblings. Indeed, the results support the position that positivity behaviours are a form of social support (Madlock & Booth-Butterfield, 2011) and siblings frequently rely on each other for social support, especially in times of crisis (Goetting, 1986). In addition, Myers (2011) suggested that one reason adult siblings maintain their relationships was because of ‘circumstance’ (i.e. they are family) and further suggested that familial tasks behaviours are an example of family ‘circumstances’. Therefore, positivity, and sharing tasks relational maintenance behaviours may not be influenced by the type of sibling bond or attachment style (Myers et al., 2001), but instead may be an essential element of all sibling relationships. Hypothesis Two Discussion. The

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hypothesis that there would be a significant difference between twin siblings and non-twin siblings on measures of liking was supported, with twins indicating higher levels of liking than non-twin siblings. . This result is consistent Rubin’s (1973, cited in Canary, Stafford, & Semic, 2002) suggestion that liking was based on, amongst other things, perceived similarity. Tenney, Turkheimer and Oltmanns, (2009) also posited that greater personality similarity was associated with mutual and increased liking between peers. As twin studies have demonstrated, the personality of identical twins is very similar (Segal, 2013), therefore, it is suggested here that ‘implicit egotism’ (i.e. an unconscious tendency to prefer things that resemble the self) (Pelham, Carvallo, & Jones, 2005) may offer one explanation for the higher liking scores amongst twin dyads compared to non-twin dyads. Similarly, people tend to like whatever reminds them of themselves (Tenney, Turkheimer and Oltmanns, 2009). Strengths, Limitations and Future Research. As far as the authors are aware, no research to date has examined differences in the use of relational maintenance behaviours between twin and non-twin siblings. A strength of the present study was that it addressed this gap in the literature and extended the research on the differential use of relational maintenance behaviours between these dyads. In addition, the relatively large number of twin siblings recruited for this study was a positive feature which allowed for a valid comparison between twin siblings and

non-twin siblings. Furthermore, much of the literature reported in this study focused on sibling relationships in childhood, while this study examined sibling relationships in adulthood. Certain limitations should be noted when interpreting the findings. In additional, this study only examined five relational maintenance behaviours and siblings may use other relational maintenance behaviours which are not contained within Carney and Stafford’s scale. Therefore, observing twin relationships in action and comparing them with non-twin sibling relationships in domains such as non-verbal communication, touch and proximity would be a very worthwhile and valuable exercise (Tancredy & Fraley, 2006). In addition, all siblings in this study reported on a same-sex sibling. This was in keeping with similar studies examining siblings’ relationships ((e.g. Fowler, 2009; Neyer, 2002; Neyer & Lang, 2003). Further research could consider including analysis on opposite-sex siblings which may provide a different perspectives and a richer analysis of sibling relationships. Another limitation of the current study was that it did not focus on the sibling relationship from the perspective of both members of the dyad. Similar to previous research on close relationships (e.g. Myers et al., 2001 Mikkelson et al., 2011; Tancredy, & Fraley, 2006), this study focused on how individuals related to other siblings in their lives. While this informa-

Empirical Investigations

TWIN AND NON-TWIN USE OF RELATIONAL MAINTENANCE BEHAVIOURS AND MEASURES OF SIBLING LIKING tion is valuable, future research could garner more detailed analysis of the sibling relationship by focusing on the sibling dyad instead of individuals (Tancredy, & Fraley, 2006). Finally, this study was conducted at only one point in time; therefore changes in sibling relationships cannot be determined. Riggio’s (2000) The Lifespan Sibling Relationship Scale offers a possible alternative measure, which assesses general attitudes towards sibling relationships across the span of adulthood. Pietilä et al. (2012) acknowledged that twin relationship patterns are fluid and can change over time. Therefore, it is possible that differences between twin siblings and non-twin siblings in their use of relational maintenance behaviours, and measure of liking may change as a function of developmental stage. Further research could use this measure and examine whether there is a difference in sibling relationship attitudes between twin siblings and non-twin siblings across the lifespan. Conclusion. Using the relational maintenance behaviour scale to operationalise the concept of sibling ‘bond’ (Myers et al., 2001), the findings of this study supports the notion that generally twin siblings appear to be closer than non-twin siblings (Neyer, 2002; Tancredy & Fraley, 2006). The results of the present study found significant differences between twin siblings and non-twin siblings in their use

of openness, assurances, and networks relational maintenance behaviours compared to non-twin siblings. However, no significant negative difference was found between the two groups in their use of positivity and sharing tasks relationship maintenance behaviours. Twin siblings also tended to like their siblings more than nontwin siblings. These findings contribute to the body of research conducted on the use of relational maintenance behaviours in sibling relationships and support the notion that the use of such behaviours varies among sibling relational types. These findings also suggest that ‘implicit egotism’ (Pelham, Carvallo, & Jones, 2005) may explain the higher liking scores amongst twin dyads compared to non-twin dyads. References Bank, L., Burraston, B., & Snyder, J. (2004). Sibling conflict and ineffective parenting as predictors of adolescent boys’ antisocial behavior and peer difficulties: additive and interactional effects. Journal of Research on Adolescence, 14, 99–125. Canary, D., J & Stafford, L. (1992). Relational maintenance strategies and equity in marriage. Communication Monographs, 59, 243-267. Canary, D. J., Stafford, L., & Semic, B. A. (2002). A panel study of the associations between maintenance strategies and relational characteristics. Journal of Marriage and Family, 64(2), 395406.

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Cicirelli, V. G. (1995). Sibling relationships across the lifespan. London: Plenum Press. Fraley, R. C., & Tancredy, C. M. (2012). Twin and sibling attach ment in a nationally representative sample. Personality and Social Psychology Bulletin, 38, 308-316. Fowler, C. (2009). Motives for sibling communication across the lifespan. Communication Quarterly, 56, 51-56. Goetting, A. (1986). The developmental tasks of siblingship over the life cycle. Journal of Marriage and Family, 48, 703-714. Graham, E. E., Barbato, C. A., & Perse, E. M. (1993). The interpersonal communication motives model. Communication Quarterly, 41, 172–186. Hamilton, W. D. (1964). The genetical evolution of social behavior: I & II. Journal of Theoretical Biology, 7, 1–52. Lee, T. R., Mancini, J. A., & Maxwell, J. W. (1990). Sibling relationships in adulthood: contact patterns and motivations. Journal of Marriage and the Family, 52, 431-440. Lewis, D. (2011). The sibling uncertainty hypothesis: facial resemblance as a sibling recognition cue. Personality and Individual Differences, 51, 969– 974. Loehlin, J. C. (1989). Partitioning environmental and genetic contributions to behavioral development. American

Psychologist, 44, 1285-1292. Madlock P. E., & Booth-Butterfield, M. (2011).The influence of relational maintenance strategies among coworkers. Journal of Business Communication, 21-49. McLaren, I. A. (2012). The use of quantitative and qualitative methods in the analysis of academic achievement among undergraduates in Jamaica. International Journal of Research & Method in Education, 35(2), 195-216. Mikkelson, A. Myers, S. A., & Hannawa, A. F. (2011). The differential use of relational maintenance behaviors in adult sibling relationships. Communication Studies, 62, 258–271. Neyer, F. J. (2002). Twin relationships in old age: A developmental perspective. Journal of Social and Personal Relationships, 19, 155-177. Neyer, F. J., & Lang, F. R. (2003). Blood is thicker than water: kinship orientation across adulthood. Journal of Personality and Social Psychology, 84, 310321. Nozaki, M., Fujisawa, K. K., Ando, J., & Hasegawa, T. (2012). The effect of sibling relationships on social adjustment among Japanese twins compared with singletons. Twin Research and Human Genetics, 15(6), 727-736. Pallant, J. (2007). SPSS survival manual (3rd ed.). Maidenhead, England: Open University Press.

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TWIN AND NON-TWIN USE OF RELATIONAL MAINTENANCE BEHAVIOURS AND MEASURES OF SIBLING LIKING Pelham, B. W., Carvallo, M., & Jones, J. T. (2005). Implicit Egotism. Current Directions in Psychological Science, 14, (2), 106-110. Penninkilampi-Kerola, V., Moilanen, I., & Kaprio, J. (2005). Co-twin dependence, social interactions, and academic achievement: a population-based study. Journal of Social and Personal Relationships, 22, 519540. Pietilä, S., Björklund, A., & Bülow, P. (2012). Older twins experiences of the relationship with their co-twin over the life course. Journal of Aging Studies, 26, 119-128. Plomin, R., Reiss, D., Hetherington, E. M., Howe, G. W. (1994). Nature and nurture: genetic contributions to measures of the family environment. Developmental Psychology, 30(1), 32-43. Ponzetti, J., & James, C. M. (1997). Loneliness and sibling relationships. Journal of Social Behavior and Personality, 12, 103-112. Psychological Society of Ireland, (2011). Code of Professional Ethics. Dublin: PSI. Rasch, D., & Guiard, V. (2004). The robustness of parametric statistical methods. Psychology Science, 46(2), 175-208. Riggio, H. R. (2000). Measuring attitudes toward adult sibling relationships: the lifespan sibling relationship scale. Journal of Social and Personal Rela-

tionships, 17, 707-728. Rubin, Z. (1970). Measurement of romantic love. Journal of Personality and Social Psychology, 16, 265-273.. Segal, N. L. (1993). Twin, sibling, and adoption methods: tests of evolutionary hypotheses. American Psychologist, 48, 943-956. Segal, N. L. (2000). Entwined lives – twins and what they tell us about human behaviour. London: Penguin Books. Segal, N. (2013). Personality similarity in unrelated look-alike pairs: addressing a twin study challenge. Personality and Individual Differences, 54, 23–28. Sternberg, R. J. (1987). Liking versus loving: A comparative evaluation of theories. Psychological Bulletin, 102, 331-345. Stieger, S., Reips, U. D., & Voracek, M. (2007). Forced-response in online surveys: bias from reactance and an increase in sex-specific dropout. Journal of the American Society for Information Science and Technology, 58(11), 1653-1660. Tancredy, C. M., & Fraley, R. C. (2006). The nature of adult twin relationships: an attachment-theoretical perspective. Journal of Personality and Social Psychology, 90, 78-93.

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Tenney, E. R., Turkheimer, E. & Oltmanns. T. F. (2009). Being liked is more than having a good personality: the role of matching. Journal of Research in Personality 43, 579–585. Tucker, C. J., Updegraff, K. A., McHale, S. M., & Crouter, A. C. (1999). Older siblings as socializers of younger siblings’ empathy. Journal of Early Adolescence, 19, 176 – 198. Van Volkom, M. (2008). Sibling relationships in middle and older adults. Marriage and Family Review, 40, 151-170. Whiteman, S. D., McHale, S. M., & Crouter, A. C. (2007). Competing processes of sibling influence: observational learning and sibling deidentification. Social Development, 16, 642 – 661.

Student Psychology Journal, 2013, 53-71

Preadolescents’ Perceptions of Cross-Gender Toy Preferences in Early Childhood and Gender Atypical Behaviour in Adolescence: A Qualitative Exploration Ann Prendergast Trinity College, Dublin Correspondence: predean@tcd.ie

abstract

This qualitative study explored preadolescents’ perceptions towards cross-gender toy preferences in childhood and gender atypical behaviour in adolescence. Twenty-three participants aged 11-12 years (11 male, 12 female) evaluated two vignette-style conflict situations in which a male and female character demonstrated gender nonconformity. Semi-structured interviews were administered and a thematic analysis was employed to interpret the findings. Results illustrated that eleven preadolescents adhered to traditional gender stereotypes in relation to toy preferences, while a comparable number (nine participants) displayed flexibility in gender stereotypic beliefs. Societal influence on the enforcement of gender stereotypes emerged as a key theme. The rigid definitions of masculinity that boys are subject to contrasted with the relative freedom of gender expression afforded to girls. Participants believed that gender nonconforming boys would be targets for bullying. Implications for schoolbased bullying prevention and intervention were discussed. Introduction Gender stereotypes have been defined as beliefs about the behaviours and characteristics that men and women are likely to possess (Ashmore & Del Boca, 1986). They are prescriptive in nature and dictate how an individual ‘should’ behave

(Deaux & LaFrance, 1998). Children gain a rudimentary awareness of gender stereotypes from an early age and preferences for sex-typed toys is one of the most consistent and well established features of gender development in children (Serbin, Poulin-Dubois, Colburne, Sen, & Eichstedt, 2001). Visual preferences

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for sex-typed toy objects have been shown in male infants as young as 9 months old (Campbell, Shirley, Heywood, & Crook, 2000). This suggests that stereotyped toy preferences may be evident long before infants acquire a sense of gender identity, whereby they can accurately identify their own gender status at 24 months (Kohlberg, 1966; Kohlberg & Ullian, 1974). By the age of 5, children know a range of gender stereotypes which are often ‘amusing and incorrect’ (Martin & Ruble, 2004).

cording to Williams and Pleil (2008) the idea that toy preferences are influenced by genetics and hormones has faced ‘considerable resistance’. However, the possibility remains that biological factors may contribute to sex-typed toy preferences. Girls with congenital adrenal hyperplasia (CAH), for example, who have been exposed to high prenatal levels of adrenal androgen, show an increased preference for masculine toys (Berenbaum & Hines, 1992; Berenbaum & Snyder, 1995).

Young children are extremely constrained by categorical thinking when judging if a toy is ‘for boys’ or ‘for girls’ (Halim, Ruble, & Amodio, 2011; Martin, Woods, & Little, 1990). They use stereotyped assumptions about gender when selecting toys for themselves, and also for other children (Lobel & Menashri, 1993; Martin & Ruble, 2004). Most children prefer toys that are stereotyped as gender appropriate for their own sex (Alexander, Wilcox & Woods, 2009; Connor & Serbin, 1977; for review, see Ruble, Martin & Berenbaum, 2006). While girls prefer feminine or neutral toys, boys primarily play with masculine toys (Martin, Eisenbud, & Rose, 1995). Recent research has shown almost parallel toy preferences among male and female rhesus monkeys (Hassett, Siebert, & Wallen, 2008). Despite the fact they had never encountered the toys previously; male rhesus monkeys preferred wheeled mechanical toys and showed a strong dislike towards plush toys. Ac-

Researchers have consistently found that toys are gender stereotyped in very predictable ways (Blakemore & Centers, 2005). In one study Campenni (1999) asked adults to rate children’s toys according to their gender appropriateness. Toys considered most appropriate for boys were action figures, weapons, vehicles and sports gear. Female appropriate toys included those relating to ‘domestic tasks, beauty enhancement, or child rearing’ (Messner, 2000). Dolls (which are consistently seen as feminine toys) are routinely described as objects that support opportunities for nurturance and as a result girl’s play often involves acting out family roles (Blakemore et al., 2005; Campbell et al., 2000; Maccoby, 1998; Miller, 1987). Masculine toys however, emphasise violence and aggression (Klugman, 1999). Blakemore and Centers (2005) argued that violence was the most problematic aspect associated with strongly masculine toys. As one research study has shown, even a

Empirical Investigations

PREADOLESCENTS’ PREFERENCES AND GENDER ATYPICAL BEHAVIOUR feminine domestic toy (a mixing-bowl) can be easily reimagined by boys into something exciting and dangerous, namely as ‘a drill and a machine gun’ (Schau, Kahn, Diepold, & Cherry, 1980). Martin and colleagues (1995) found that regardless of toy attractiveness, young children tended to avoid toys which were labelled as being for the other sex (the ‘hot potato’ effect). Boys in particular are more likely to restrict themselves to sextyped toys and avoid attractive cross-gender toys (Frey & Ruble, 1992). Ross and Ross (1972) wondered if preschool boys would accept a cross-gender toy if they were encouraged to do so by their favourite teacher. Not only did all of the boys resist the teacher’s suggestion, but they also tried to discredit her advice. Some told the researcher she must be ill while others implied that she was overworked (‘Teacher has too much to do today’). In middle childhood children develop more sophisticated reasoning abilities and start to appreciate the many similarities to be found in males’ and females’ behaviour (Crouter, Whiteman, McHale, & Osgood, 2007; Martin & Ruble, 2004). As a result they tend to become more flexible in their gender attitudes (i.e. their stereotype rigidity begins to wane). By approximately 7 or 8 years children are less likely to accept gender stereotypes as being ‘fixed’ or ‘morally right’ (Halim et al., 2011).

Girls begin to shift away from rigid

feminine gender roles in middle childhood, whereas the majority of boys remain unwaveringly masculine and interact mainly with same-sex peers (Maccoby, 1998; Ruble & Martin, 1998). Why might this be? Children are influenced by social and environmental cues and studies have shown that parents, peers and teachers criticise or punish boys (more so that girls) for engaging in cross-gender behaviours (Fagot, 1978; Langlois & Downs, 1980; Pasterski, Geffner, Brain, Hindmarsh, Brook & Hines, 2005). Parents routinely express unease with their sons undertaking behaviours which might be considered traditionally feminine (Freeman, 2007; Sandnabba & Ahlberg, 1999). According to Kane (2006) parents responded negatively to their sons dressing up in ‘pink or frilly clothing’ and were uncomfortable at the thought of their son’s exhibiting ‘excessive emotionality’. Fathers as opposed to mothers have been shown to have a lower tolerance for gender atypical behaviour in their sons’ play (Lytton & Romney, 1991; Goldberg, Kashy, & Smith, 2012). Fathers in the Kane study (2006) feared that gender nonconforming sons would be perceived as ‘gay’ and would prefer same-sex relationships in adulthood. The same concern was not expressed in comments about daughters. Leisure activities also tend to be gender stereotyped in childhood. Boys tend to play more physically strenuous sports and team sports such as basketball and

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football (Cherney & London, 2006; Maccoby, 1998) whereas girls tend to engage in more sedentary, non-competitive, indoor activities. Some girls may be drawn towards masculine activities as they are highly valued by society (Feinman, 1981; Frey & Ruble, 1992). Toyama (1997), for example, discovered that successful female administrators played more football and participated in more team activities in childhood when compared to their less successful female colleagues (Toyama, 1997 as cited in Giuliano, Popp, & Knight, 2000). According to Kane (2006) parents often celebrate and encourage gender atypical behaviour in their young daughters, and refer fondly to their daughters as ‘tomboys’. Retrospective studies have revealed that up to three-quarters of women recall being tomboys in middle childhood (Halim et al., 2011). Some researchers claim that girls are given more gender leeway than boys in early childhood because parents believe that girls will ‘outgrow’ any cross-gender behaviour by adolescence (Sandnabba & Ahlberg, 1999). Adolescence is a time when traditional gender roles may be intensified, creating a curvilinear ‘retreat to stereotypes’ age trend (Katz & Ksansnak, 1994; Perry & Pauletti, 2011; Ullian, 1976 as cited in Percival, 1985). In a study conducted by Stoddart and Turiel (1985) adolescents were asked to consider a series of gender role deviations (e.g. a boy wearing nail polish). Their results revealed that adoles-

cents were less tolerant of gender atypical behaviour than younger children, despite understanding that such behaviours were a matter of personal choice. Gender differences are accentuated during the onset of puberty and young people may face intense pressure to ‘fit in’ or assume traditional dating roles (Alfieri, Ruble, & Higgins, 1996; Smith & Leaper, 2006). If adolescents wish to meet these social expectations of gender they must adhere to social conventions and avoid any gender nonconforming behaviours (Hill & Lynch, 1983; Menon, 2011; Yunger, Carver, & Perry, 2004).

Gender atypical behaviour in childhood and adolescence typically has a negative impact on peer relations (Langlois & Downs, 1980). Boys in particular are victimised by peers for exhibiting gender nonconforming behaviours and punishment from peers often begins at a very early age (Boldt, 2002; Landolt, Bartholomew, Saffrey, Oram, & Perlman, 2004, Saghir & Robins, 1973). Young and Sweeting (2004) argued that gender nonconforming boys faced more rejection, had fewer male friends and experienced more loneliness than their gender typical male peers. Kimmel and Mahler (2003) argued that negative attitudes toward gender atypical behaviour are the foundations for bullying. Higdon (2011) suggested that some bullies act as gender enforcers, teasing other boys for not being ‘man enough’. Pascoe (2011)

Empirical Investigations

PREADOLESCENTS’ PREFERENCES AND GENDER ATYPICAL BEHAVIOUR stated that these bullies were less concerned with sexual orientation but rather with ‘gender expression’. She implied that male effeminacy (i.e. lack of stereotypical masculinity) is the reason why some gender nonconforming boys become perpetual victims of bullying. While female gender roles have expanded in recent decades, Pollack (1998) has suggested that boys remain locked in a ‘gender straitjacket’. Repeated peer victimisation has been shown to lead to increased rates of depression and suicide among gender nonconforming children (Higdon, 2011; Pollack, 1998) and negative correlations have been found between gender atypical behaviours in childhood and psychological well-being in adulthood, especially with men (Skidmore, Linsenmeier, & Bailey, 2006; Weinrich, Atkinson, McCutchan, & Grant, 1995). The Present Study. Thus far the majority of studies relating to cross-gender toy preferences and gender atypical behaviour in childhood and adolescence have been conducted with parents (e.g. Kane, 2006; Sandnabba & Ahlberg, 1999) or with preschool children in early childhood (e.g. Ross & Ross, 1972). There has been very little research into the attitudes of children in middle childhood, especially preadolescence, regarding such phenomenon and this is a considerate gap in the literature. Research has suggested that adolescents are more stereotyped in their gender roles than they were in middle

childhood (e.g. Stoddart & Turiel, 1985). Therefore preadolescence could mark a period of developmental change in terms of gender stereotypes. The transition from childhood into adolescence itself may influence gender attitudes, as gender differences become more salient during the onset of puberty. The aim of the present study was to evaluate preadolescent participants’ perceptions of cross-gender toy preferences in early childhood and gender atypical behaviour in adolescence. This aim was assessed by reviewing children’s responses to two vignette-style conflict situations. Each conflict situation contained examples of deviations from traditional gender roles. A qualitative approach was used to with the intention of gaining insight into participants’ attitudes and beliefs (Buston, Parry-Jones, Livingston, Bogan, & Wood, 1998). Method Participants. Participants comprised of 23 primary school students (11 male and 12 female) all of whom were in sixth class. The age range was between 11-12 years old. Participants were recruited voluntarily from an urban coeducational primary school. A sixth class was chosen by the school principal and all of the children in the class were invited to take part. Materials. During the semi-structu-

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red interview participants were asked to read two vignette-style conflict situations involving hypothetical characters. These conflict situations were adapted from Terrance Q. Percival’s (1985) study titled ‘The Development of Gender Constructs’. Situations 1 and 2 follows: Situation 1. Joe and Jill Johnson are twins, and today is their fourth Birthday. The Johnson family are poor and the brother and sister usually only get one small present each. So when two presents from a kind old aunt arrived in the post this morning the children got very excited! The presents were wrapped in the same wrapping paper and there was no name tag on either present. The children quickly opened the presents. Inside one was a beautiful purse and inside the other was a pair of boxing gloves. Joe really likes the beautiful purse. He enjoys carrying it around with him, putting things in and out of it. Jill is really excited about a pair of boxing gloves because she wants to be a boxer when she grows up. Since their aunt did not say which child should get which present, it was up to the parents to decide who got the purse and who got the boxing gloves. The parents decide that Jill should get the purse and that Joe should get the boxing gloves. Their reason was that a boy should get a boy’s present and that a girl should get a girl’s present.

Situation 2. Joe is now thirteen years old. He sometimes plays sports like football with the other boys, but he much prefers quiet indoor activities. Joe enjoys reading and sometimes he cries when a book is sad. He likes drawing and spends hours on his pictures. Lately he had become interested in writing poetry, although he was shy about reading his poems to other people. Joe often tells his family he loves them. He is a very sensitive boy and hates hurting people’s feelings. Joe’s father is upset. He thinks Joe is too quiet, sensitive, and loving. His father wants Joe to be more aggressive and more adventurous like other boys. He thinks Joe should stop all his quiet indoor activities, like reading and writing poems. Joe’s father tells Joe to be more manly and wants him to do different activities. Joe was sorry that his father was upset and wanted to please him, but Joe really didn’t like doing the things his father wanted him to do. For the present study the conflict situations were simplified in terms of their language content for readability purposes. Similarly, some non-relevant cultural references from the original conflict situations were adapted to suit an Irish context. A hockey stick and puck (a Canadian example of a stereotypical boy’s present) became a pair of boxing gloves. An inter view schedule (Appendix A) with eight

Empirical Investigations

PREADOLESCENTSâ&#x20AC;&#x2122; PREFERENCES AND GENDER ATYPICAL BEHAVIOUR questions relating to the two situations was developed. Each potential participant received an informational parental consent form which was distributed by their class teacher. Furthermore, participants were given an additional informational consent form before the interview began. Present on the table during the interviews was a laminated visual aid containing two Clip Art images of the Situation 1 toy presents: a purse and a pair of boxing gloves. The interviews were recorded using an Olympus VN-702 digital audio recorder and transcribed on a Samsung laptop. Procedure. The school principal was contacted and permission to conduct the interviews was obtained. Parental informational consent forms were distributed through the class teacher. Prior to the individual interviews, the researcher introduced herself to the class. Provided a letter of parental consent was returned and signed, pupils were asked to take part in a short 10 minute one-on-one interview. Interviews took place in the assistant principalâ&#x20AC;&#x2122;s office. Upon arrival at the office, participants were greeted by the researcher and the signed parental consent forms were collected. The participants were assured that they were not being compelled to take part in the study. They were also reminded that the interview would be recorded. The design of the semi-structured interview was explained to the participants. The researcher clarified what the participant would be asked to do during

the interview using simple verbal instructions. The participants were then given an additional consent form before the interview began. Using the prepared interview schedule (Appendix A) the researcher encouraged participants to respond to the conflict situations and give reasons for their answers. Upon completing the interview participants were debriefed verbally and thanked for their contribution. Data Analysis. All interviews were transcribed verbatim to ensure an accurate transcript of participantsâ&#x20AC;&#x2122; responses. Transcripts were then analysed using a thematic analysis in accordance with the guidelines set out by Braun and Clarke (2006). Themes were identified through an inductive analysis of the data. Transcripts were read several times by the researcher and notes were made in the margins of meaningful units, such as key words and phrases. When all of the data coding was complete, a long list of identified codes was created. The codes were then sorted into potential themes. The themes were reviewed, and problematic themes were adjusted and refined. Subthemes were identified and a thematic map was created. Another researcher familiar with thematic analysis then openly coded four of the transcripts and identified themes. Only themes which were verified by both researchers were included in the final results to ensure reliability. Results

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Table 1: Themes and Sub-themes

As can be seen in Table 1 four primary themes emerged following a thematic analysis. Furthermore, eight sub-themes were also discovered and will be outlined here.

Note 1: Res. = Researcher Par. = Participant

Note 2: (P11-11F.L16-19) = Participant 11, age 11, female, lines 16-19 Note 3: Casual speech was transcribed orthographically. Contractions were only used when produced by speaker as follows:

Note 4: Speaker pauses and restarts are indicated with double dash surrounded by spaces (i.e. -- )

1. Adherence to Traditional Gender

Stereotypes: (Toy Preferences & Physical Activity and Peers). 1a. Toy Preferences. Eleven participants’ adhered to traditional gender stereotypes in relation to toy preferences. They believed that biological sex alone should determine who got the ‘girl’s present’ and who got the ‘boy’s present’ (e.g. P11-11F.L9). These participants tended to disregard the character’s own preference for cross-gender toy play (e.g. P19-12F.L10-17) and while they typically did not elaborate on their reasoning, some presented stereotypical arguments. Par.: -- They should give her (Jill) the purse because she’s a girl and she should want the purse (P05-12F.L2) Nine participants did not adhere to traditional gender stereotypes. These participants took into account the character’s preferences and decided that they should receive whichever toy they wanted (e.g. P15-11F.L1-13). One participant stated that giving them toys purely based on their

Empirical Investigations

PREADOLESCENTS’ PREFERENCES AND GENDER ATYPICAL BEHAVIOUR biological sex would be a waste of a toy as they would not ‘use’ them (P02-12F. L13). Two participants displayed a more advanced understanding of sexism, while another was concerned with freedom of choice. Par.: -- I think it’s kind of sexist the way they gave a girl a purse. Maybe the girl (Jill) doesn’t want a purse (P03-11F.L9) Par.: If he (Joe) likes the purse, doesn’t matter what gender he is. He just likes it. So he should be able to have it (P21-12M. L8) 1b. Physical Activity and Peers. When asked to define ‘manly activities’ all participants gave sports or a particular sport as an example. Nineteen participants mentioned a team sport or ‘boy’s sport’ such as football, rugby and hurling (e.g. P18-11M.L26). ‘Active and rough sports’ were considered manly (P15-11F.L24). Participant’s believed that sports encouraged socialization with same-sex peers as sports were something ‘other boys would naturally do’ (P08-12M.L35). One participant indicated that ‘getting a bit stronger’ (P22-11M.L28) was also manly thing to do, while another participant stressed the importance of relationships with same-sex peers in order to avoid appearing weak. Par.: -- He (Joe) should still try and mix with the other boys more Res.: Yeah, and why do you think he should do that? Par.: Just so he could -- I dunno. Not be so weak or something. Or too sensitive or

anything like that (P06-12F.L55-57) 2. Society and the Enforcement of Gender Stereotypes: (Bullying & Conforming to Gender Norms). 2a. Bullying. Three participants were very concerned with social ‘norms’ and what the majority would think (e.g. P12-11F.L65). Another participant expressed that while he themselves did not have any ‘problem’ with gender atypical behaviour, others in society would (P07-12M.L16-19). Three participants believed that a young boy carrying a purse around would be an invitation for bullying. Res.: Now Joe’s four here, but imagine he’s an older boy, do you think that would make a difference? Par.: Well if he has like a purse and some boys are mean, then they might slag him and they might keep it against him when he gets older (P10-12M.L16-17) Other participants suggested that a young boy’s sensitive nature and preference for indoor activities would hinder him in future fights. Par.: ‘Cos like. He (Joe) might like, get into some trouble one day and he’ll be real sensitive inside (P01-12F.L45) Par.: (Joe should) play more football and then if he’s ever in a fight he’s able to like fight the boy (P10-12M.L30) 2b. Conforming to Gender Norms. Twelve participants assumed that a four year old boy would grow out of his gender atypical

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behaviour (e.g. P08-12M.L20-27). These participants anticipated that the male character Joe would conform to conventional gender norms by age thirteen. Par.: When you’re four you don’t really know -- Like, sometimes you wouldn’t know what more girlish and what’s more boyish Res.: Yeah? Par.: But then like when -- If he were older he’d probably say “oh no I’d like the boxing gloves” (P16-11F.L19-21) 3. Categorising Gender Atypical Behaviour through Use of Labels: (Effeminacy and Homosexuality & Tolerating ‘Tomboys’). 3a. Effeminacy and Homosexuality. Five participants described the male character Joe as being ‘gay’ for showing a preference for a purse (e.g. P0512F.L27). This labelling occurred when Joe was both four and thirteen years old (e.g. P20-11M.L11-14). Three participants felt hesitant saying the word ‘gay’ openly in the interview until given permission to speak freely. Par.: And maybe the boy (Joe) wants the purse, for reasons I’m not gonna say Res.: You can say the reasons Par.: Okay he’s gay. He’s obviously, he’s completely gay (P03-11F.L11-13) The remaining participants concluded that Joe’s behaviour was ‘weird’, ‘strange’, ‘not normal’ and ‘unusual’ (e.g. P09-11F.L31, P13-12M.L17, P08-12M. L48 & P07-12M.L23).

3b. Tolerating ‘Tomboys’. Two participants labelled the female character Jill a ‘tomboy’ for her cross-gender toy preference (e.g. P20-11M.L6). The majority of participants accepted her preference for a pair of boxing gloves without any labelling. One female participant referenced ‘Katie Taylor’ an Irish female boxer and Olympic champion (P12-11F.L39) who is a prominent figure in the Irish media. There was a question of double standards when it came to the differential labelling of the male and female characters. Par.: If she (Jill) wants to be a boxer, fine enough. But giving the guy (Joe) a purse isn’t exactly -Res.: Isn’t exactly what? Par.: -- Right (P07-12M.L8-10) 4. Parental Support and Understanding: (Acceptance and Encouragement & Compromise). 4a). Acceptance and Encouragement. Nearly half of the participants were critical of the parental characters. Ten participants believed that Joe should be allowed pursue his own interests and/or be free to ‘do what he wants’ (e.g. P18-11M.L47). Similarly, ten participantsexpressed that his father should either accept Joe’s interests or ‘let him be’ (P08-12M.L50) rather than trying to change him. Res.: -- So do you agree with Joe’s dad then? Par.: No Res.: Why not? Par.: Because he’s trying to make his son

Empirical Investigations

PREADOLESCENTS’ PREFERENCES AND GENDER ATYPICAL BEHAVIOUR (into) something his son doesn’t want to be (P19-12F.L38-41) However, eight participants were not critical of Joe’s father and felt they understood his motives. Par.: -- He doesn’t want him (Joe) growing up, being like a sissy and like, being weak and all (P13-12M.L39) Eight participants were concerned that his father was ‘forcing him’ to do things that he simply didn’t want to do, which they felt was wrong (e.g. P15-11F. L32-37). One participant alleged that Joe was ‘being pushed’ into boxing (P03-11F. L51) and took issue with his father trying to control him. Par: Because it’s not his, the dad’s decision. He’s not the kid. He doesn’t have control over what the kid wants to do, and what he (Joe) likes. (P03-11F.L41) One participant suggested that parents should actively encourage their children’s interests, while another participant expressed that parents had a duty to support their child’s ‘dreams’ (P18-11M.L9). Two participants suggested that parents should ‘respect’ their children’s opinions (e.g. P21-12M.L47-49). 4b. Compromise. Eight participants expressed that Joe should attempt a compromise with his father by giving some of his suggestions a ‘try’ (e.g. P02-12F. L43-45). It was also recommended that

Joe learn to communicate with his father better. Par.: Maybe he should say to his dad that “I’ll give it a go, but if I don’t like can I stop?”(P22-11M.L35) Par.: Em. Well, I’d say he could like try a sport and see if he likes it Res.: Yeah? Par.: -- But if he can’t find one he likes then just tell his dad that he doesn’t really want to do sports (P16-11F.L41-43) Discussion The aim of the present study was to evaluate preadolescent participants’ perceptions of cross-gender toy preferences in early childhood and gender atypical behaviour in adolescence. Four main themes emerged from the data: adherence to traditional gender stereotypes, society and the enforcement of gender stereotypes, categorising gender atypical behaviour through use of labels, and parental support and understanding. The participants in the present study were 11-12 years old, an age range which was overlooked in Stoddart and Turiel’s (1985) study in which participants ranked sex-role transgressions in terms of ‘wrongness’. Nonetheless, it was predicted by their U-shaped curve that gender stereotypes would be on the incline at this age. The results in the present study indicate that most preadolescents are fa miliar with traditional gender stereotypes and

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can give examples when the question requires them to (e.g. ‘what kind of manly activities do you think Joe’s Dad is talking about?’). However, there was a noticeable divide amongst participants when it came to using gender stereotypical reasoning as a form of conflict resolution. Nearly half of the preadolescents (eleven participants) displayed gender stereotype rigidity and adhered to traditional gender stereotypes. However a comparable number (nine participants) displayed flexibility in gender stereotypic beliefs. It is possible that the variability in responses is shaped by individual cognitive differences, in addition to the diverse social contexts in which participants are growing up. According to Ullian (1976) children typically perceive differences between masculinity and femininity across a sequence of three developmental levels: biological, societal and psychological. In line with Ullian’s findings, participants in the present study revealed similar trends in response to cross-gender toy preferences. At a biological level, eleven participants used the character’s sex as rigid classification tool to determine who got the ‘boy’s present’ and who got the ‘girl’s present’. It is possible that these participants believe adherence to traditional gender roles is biologically predetermined rather than voluntary. At a societal level, three participants were convinced that the gender nonconforming male character would be subject to social disapproval and would

face hostility from same-sex peers. There was little concern shown for the female character’s gender atypical behaviour at a societal level. At a psychological level, nine participants responded free of the rigid stereotyping found at the biological and societal levels. When considering which toy each character should be given these participants highlighted the characters’ individual preferences and expressed that they should get whichever toy they wanted. Unlike Ullian’s study, participants did not show any evidence of a sequential agetrend (i.e. 12 year olds were just as likely as 11 year olds to give biological reasoning). Society and the enforcement of gender stereotypes emerged as a primary theme in the present study. A sub-theme of bullying emerged in line with previous research (Higdon, 2011; Kimmel & Mahler, 2003; Pascoe, 2011). Three participants stated that a young boy who enjoyed carrying a purse around would provoke bullying, especially from same-sex peers. In this respect preadolescents mirrored the fears of Higdon (2011) concerning the large role that gender stereotypes play in the cycle of bullying. Some of the participants were uncomfortable with the male characters’ gender atypical behaviour and branded him ‘weak’ and a ‘sissy’ illustrating their need to enforce traditional notions of gender. It can be argued that these participants use societal norms (perhaps unintentionally) as a justification for criticising boys

Empirical Investigations

PREADOLESCENTS’ PREFERENCES AND GENDER ATYPICAL BEHAVIOUR who exhibit gender atypical behaviour. Previous research has shown that fathers in particular fear their sons will be perceived as ‘gay’ if they exhibit gender atypical behaviour (Kane, 2006; Sandnabba & Ahlberg, 1999). The present study confirms that these fears have merit. Although twelve participants believed that the male character Joe would ‘outgrow’ any gender atypical behaviour by age thirteen, five participants speculated that Joe was ‘gay’. This ‘gay’ labelling occurred when Joe was both four and thirteen years old and was used as a prescriptive explanation for the character’s nonconformity. Even participants who stated that there was ‘nothing wrong’ with Joe’s behaviour (e.g. P02-12F.L23) assumed, in a matter-of-fact way, that boys who exhibited traditionally feminine behaviour must be ‘gay’. This inference illustrates a distinct problem with the rigid definitions of masculinity. That is, if young boys do not conform and adhere to the stereotypical definitions of masculinity they will be labelled a homosexual. It is apparent from both Pollack’s (1998) research and the present study’s results, that female gender roles have expanded in recent decades and females are no longer subject to rigid definitions of femininity. The majority of participants accepted the female character’s gender atypical behaviour and she was not subject to the same homosexual labelling as the male character. One participant even

expressed that forcing the female character Jill to have a purse that she didn’t want was ‘sexist’. It was apparent that most of preadolescents interviewed have been raised to embrace the idea that ‘girls can do anything boy cans do’ (Boldt, 2002). Previous research has shown that girls may be drawn towards masculine activities because they are highly valued by society (Feinman, 1981; Frey & Ruble, 1992) hence parents must be careful not to perpetuate the assumption that masculine activities are superior to feminine activities, with both their sons and daughters. Another issue raised in the present study was that of parental support and understanding. Participants were critical of the parental characters for not accepting and encouraging the male character Joe’s gender atypical interests. Many participants were concerned that the father character was forcing his son to take up ‘manly activities’, in which Joe displayed little interest, at the expense of his preferred quiet indoor activities. It was suggested that Joe should be free to express himself (i.e. ‘do what he wants’) by age thirteen. Clearly preadolescents take issue with overly controlling parents, especially parents who interfere in their children’s leisure activities. Research has shown that preadolescents trade their dependency on parents for a dependency on peers during their transition from childhood into adolescence (Steinberg & Silverberg, 1986). This transition period is characterised by intense peer

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pressure to conform to social norms (Crouter et al., 2007). Preadolescents may therefore resent any additional source of social pressure besides that of their peers, such as parental attempts to modify their gender atypical behaviour. Limitations and Directions for Future Research. The findings reported in this paper were limited in scope and the small sample may restrict the generalizability of the results. Future studies should consider employing a larger sample of preadolescents. Gender stereotypical attitudes in the present study showed no obvious age or sex trends. Research has suggested that parents with ‘less traditional’ gender stereotype attitudes are influential during early adolescence years (Crouter et al., 2007). Therefore a data triangulation with the inclusion of interviews with the participants’ parents could perhaps explain these individual differences in gender stereotyping. Likewise a longitudinal design would allow for repeated follow-up interviews with participants as they progress through adolescence, and would perhaps produce a gender stereotyping age trend which was not observable in the present study. Implications for Bullying: Prevention and Intervention. The findings of the present study indicate that preadolescents are highly critical of young boys who exhibit gender nonconforming behaviours. Preadolescents may be unaware of the degree to which rigid definitions

of masculinity drive gender stereotypes. Therefore classroom seminars should be employed to inform preadolescents of the social forces which underlie and perpetuate gender stereotypes and how these can lead to bullying. It is important that preadolescents understand why victimisation and labelling on the basis of gender expression should not be tolerated in a primary school environment. Preadolescents should be made aware that bullying behaviour is not a normal phase of development, and that persistent name-calling directed at the same individual is unacceptable. It is crucial that teachers and school administrators do not ‘turn a blind eye’ when they hear preadolescents engaging in gender-based verbal bullying, such as homophobic name calling. Primary schools’ anti-bullying procedures should be required to address this type of identity-based bullying specifically, within the framework of their overall code of behaviour. References Alexander, G. M., Wilcox, T., & Woods, R. (2009). Sex differences in infants’ visual interest in toys. Archives of Sexual Behavior, 38(3), 427-433. Alfieri, T., Ruble, D. N., and Higgins, E. T. (1996). Gender stereotypes during adolescence: Developmental changes and the transition to junior high school. Developmental Psychology, 32(6), 1129.

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Freeman, N. K. (2007). Preschoolers’ perceptions of gender appropriate toys and their parents’ beliefs about genderized behaviors: Miscommunication, mixed messages, or hidden truths?. Early Childhood Education Journal, 34(5), 357-366.

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Perry, D. G., & Pauletti, R. E. (2011). Gender and Adolescent Development. Journal Of Research On Adolescence, 21(1), 61-74.

Serbin, L. A., Poulin-Dubois, D., Colburne, K. A., Sen, M. G., and Eichstedt, J. A. (2001). Gender stereotyping in infancy: Visual preferences for and knowledge of gender stereotyped toys in the second year. International Journal of Behavioral Development, 25(1), 7-15.

Pollack, W. (1998). Real boys: Rescuing our sons from the myths of boyhood. New York: Random House. Ross, D. M., and Ross, S. A. (1972). Resistance by preschool boys to sex-inappropriate behavior. Journal of Educational Psychology, 63(4), 342. Ruble, D. N., and Martin, C. L. (1998). Gender development. In W. Damon (Ed.), Handbook of child psychology (5th ed., Vol. 3). New York: Wiley. Ruble, D. N., Martin, C. L. and Berenbaum, S. A. Gender development. (2006). In: Damon, W., Lerner, R. M., & Eisenberg, N. (Eds.). Handbook of Child Psychology, Social, Emotional, and Personality Development (Vol. 3). New York: Wiley. Saghir, M. T., and Robins, E. (1973). Male and female homosexuality: A comprehensive investigation. Williams and Wilkins. Sandnabba, N. K., and Ahlberg, C. (1999). Parents’ attitudes and expectations about children’s cross-gender behavior. Sex Roles, 40(3), 249-263. Schau, C. G., Kahn, L., Diepold, J. H., and

Skidmore, W. C., Linsenmeier, J. A., and Bailey, J. M. (2006). Gender nonconformity and psychological distress in lesbians and gay men. Archives of Sexual Behavior, 35(6), 685-697. Smith, T. E., & Leaper, C. (2006). Self-Perceived Gender Typicality and the Peer Context During Adolescence. Journal of Research on Adolescence, 16(1), 91-103. Steinberg, L., and Silverberg, S. B. (1986). The vicissitudes of autonomy in early adolescence. Child Development, 841-851. Stoddart, T., and Turiel, E. (1985). Children’s concepts of cross-gender activities.Child Development, 1241-1252. Toyama, J. S. (1977). Selected socio-psychological factors as related to the childhood games of successful women. In M. L. Krotee (Eds.), The dimensions of sport sociology (pp.52–59). West Point, NY: Leisure Press.

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PREADOLESCENTS’ PREFERENCES AND GENDER ATYPICAL BEHAVIOUR Ullian, D. Z. (1976). The development of conceptions of masculinity and femininity. In B. Lind and J. Archer (Eds.), Exploring sex differences (pp. 25–47) New York: Academic Press. Weinrich, J. D., Atkinson, J. H., McCutchan, J. A., and Grant, I. (1995). Is gender dysphoria dysphoric? Elevated depression and anxiety in gender dysphoric and nondysphoric homosexual and bisexual men in an HIV sample. Archives of Sexual Behavior, 24(1), 55-72. Williams, C. L., and Pleil, K. E. (2008). Toy story: Why do monkey and human males prefer trucks? Comment on “Sex differences in rhesus monkey toy preferences parallel those of children” by Hassett, Siebert and Wallen. Hormones and Behavior, 54(3), 355. Young, R., and Sweeting, H. (2004). Adolescent bullying, relationships, psychological well being, and gender-atypical behavior: A gender diagnosticity approach. Sex Roles, 50(7), 525-537. Yunger, J. L., Carver, P. R., & Perry, D. G. (2004). Does gender identity influence children’s psychological wellbeing? Developmental Psychology, 40, 572 – 582.

Student Psychology Journal, 2013, 72-86

Effects of Cathodal Transcranial Direct Current Stimulation (tDCS) on Error Awareness in Healthy Older Adults Owen Sheehy Trinity College, Dublin Correspondence: sheehyoc@tcd.ie

abstract

Online error awareness (EA) – the ability to recognise one’s errors as they occur - is a vital cognitive function that has been associated with the prefrontal cortex (PFC) and is particularly pertinent for older adults as they attempt to retain functional autonomy in their daily lives. Recent research demonstrates that applying anodal transcranial direct current stimulation (tDCS) to the right PFC of older adults can improve their online EA. This study applied cathodal tDCS to the right PFC in an attempt to disimprove levels of online EA, in accordance with the established “Anodal-Excitatory, Cathodal-Inhibitory” tDCS conventions. A repeated measures design was used, where healthy older adults (N=25) received real and sham cathodal tDCS over two sessions while completing the Error Awareness Task (EAT), a Go/No-go paradigm previously established as a measure of online EA . It was found that applying real cathodal tDCS to the PFC did not disimprove online EA. A practice effect for the EAT was identified, but this pertained only to withholding accuracy, not EA. Explanations for the lack of cathodal effect are put forward and it is argued that much currently remains unknown regarding the effects of tDCS on cognitive performance, limiting its potential for use as a viable clinical tool for enhancing EA in older adults. Introduction Error Awareness and the role of the Prefrontal Cortex. Error awareness (EA) can be defined as an executive

cognitive function that alerts individuals when their actual responses or behaviours are incongruous with their intentions, allowing for modifications to be made if necessary (Simons, 2009). One particular

Empirical Investigations

ERROR AWARENESS IN HEALTHY OLDER ADULTS form of awareness that has been conceptualised in the literature is emergent online EA, which is the ability to recognise errors as they are occurring, enabling individuals to monitor their performance within a stream of action (Toglia & Kirk, 2000). Online EA is of particular interest for the purposes of this paper. Research on the neural correlates of EA has consistently implicated the prefrontal cortex as playing a key role in this function (Ridderinkhof, Ullsperger, Crone & Nieuwenhuis, 2004). One of the most influential frameworks for conceptualising error processing is conflict theory (Botvinik, Braver, Barch, Carter & Cohen, 2001), which posits that errors are special occurrences of cognitive conflict; states in which strong response tendencies must be overcome by the intended response. Cognitive conflict is monitored by the anterior cingulate cortex (ACC) which then sends signals to the PFC to increase cognitive control during periods of high conflict. This theory has been supported by associations between ACC activity preceding errors and dorsolateral PFC activity on trials following an error (Kerns et al., 2004). The processing of errors in this way is an example of the cognitive control that is known to occur in the PFC (Miller & Cohen, 2001). Other research suggests that the PFC exerts its role in error processing by focusing attention to pertinent stimuli features and distinguishing between representations of conflicting responses (Cohen, Botvinick & Carter,

2000). Gehring and Knightsâ&#x20AC;&#x2122; (2000) error monitoring and correction model proposes that the ACC screens for errors, but is dependent on the DLPFC for the information processing necessary for identifying these errors and implementing correctional behaviour, as the ACC alone is unable to distinguish between incorrect and correct responses relative to the task at hand. Further evidence supporting this view suggests that the ACC, although necessary for detecting errors, cannot independently account for online awareness of errors or post-error behavioural modification (Hester, Foxe, Molholm, Shpaner & Garavan, 2005). It may be the case that another system â&#x20AC;&#x201C; such as the basal ganglia (Gehring & Knight, 2000) - actually executes the actions necessary for error correction, but the process whereby individuals become aware of their errors appears to be a discrete cognitive function that is linked with the PFC. Some research has highlighted notable hemispheric disassociations in the PFC. The findings of Garavan et al. (2002) highlighted PFC laterality in relation to its role in executive behavioural control, finding that the right DLPFC is heavily involved with response inhibition while the left DLPFC is more active as the individual attempts to modify their behaviour following errors. The left DLPFC may thus have a role in moderating the relevant task sets that are required for altering ones behaviour following an error. This behaviou-

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ral adjustment requires a shift in the mental set, which involves altering response criteria in accordance with the demands of the task. Garavan et al. therefore speculate that the identification of errors may rely on the maintenance of appropriate task sets in the PFC. Lesion studies have also provided insight into the role of the PFC among the various types of EA (O’Keefe, Dockree, Moloney, Carton & Robertson, 2007). Frontal lobe patients typically exhibit lower levels of both metacognitive awareness (general awareness of their own disorders) and online awareness of errors as they occur (Hoerold, Pender & Robertson, 2013). A notable finding from the Hoerold et al. (2013) study was that while metacognitive awareness was implicated equally across both right and left frontal regions, online awareness was more dependent on the right prefrontal cortex than the left. Although there may still be some unanswered questions regarding the specifics of prefrontal cortex functioning, the literature clearly suggests that it is in some way implicated with EA, and more specifically, with online EA. Error Awareness in Older Adults. The ability to detect and correct errors is particularly salient for older adults. Bettcher and Giovanetti (2009) note that EA is a key issue that must be addressed when considering the activities of daily living (ADLs) that older adults typically engage in. EA is particularly relevant when considering Instrumental ADLs

(IADLs), which are more complex and involve multiple steps over a longer period of time, such as managing one’s medication or finances (Suchy, Kraybill & Franchow, 2011). Older adults suffering from Alzheimer’s disease typically struggle while performing common ADLs and IADLs (Giovanetti, Libon, Buxbaum & Schwartz, 2002), which could be due to their impaired ability to process errors, given that Alzheimer’s disease has been associated with PFC deficits (Mathalon et al., 2003). This suggests that the capacity to become aware of and correct one’s errors is of vital importance to neurotypical healthy older adults as they engage in autonomous living. Characteristics of EA in older adults in relation to their younger counterparts have received much attention in the literature, and various trends have been identified such as older adults having a reduced capacity to learn error-specific performance monitoring techniques (Pietschmann, Endrass & Kathman, 2011) and demonstrating reduced awareness when attempting to adapt to changing demands in cognitive tasks (Band & Kok, 2000) or when presented with time constraints (Endrass, Schreiber & Kathman, 2011). As previously discussed, the PFC is a key neural substrate for EA but is vulnerable to the effects of aging such as reduced functional activation and connectivity (Grady, 2012), which could potentially account for the trends of diminished EA among older adults. The ability to become aware of one’s errors is essential for functional aut-

Empirical Investigations

ERROR AWARENESS IN HEALTHY OLDER ADULTS onomy and is therefore of vital importance for older adults. Transcranial Direct Current Stimulation (tDCS). Transcranial Direct Current Stimulation (tDCS) is a form of non-invasive brain stimulation that uses low intensity electrical currents to increase or decrease cortical excitability (Peruzzotti-Jametti, Bacigaluppi, Sandrone & Cambiaghi, 2013). This is achieved by modifying the resting potential of neuronal membranes and may facilitate neuroplasticity through long term potentiation (McKinley, Bridges, Walters & Nelson, 2012). It is generally accepted that anodal stimulation increases cortical excitability and can thus upregulate brain function, while cathodal stimulation decreases excitability and can downregulate functioning (Nitsche and Paulus, 2000), although more recent research has tended to question the universality of this assumption (Jacobson, Koslowsky & Lavidor, 2012). Research has shown that application of tDCS to specific cranial locations can modulate various cognitive functions, such as change detection in the posterior parietal cortex (Tseng et al., 2012) and episodic memory in the left DLPFC (Javadi Arjomand, 2011). It is important to recognise that multiple factors can influence an individualâ&#x20AC;&#x2122;s susceptibility to tDCS, with some research suggesting that females are more responsive to stimulation than males (Boggio, Rocha, da Silva & Fregni, 2008). Advantages of tDCS include its ease of

use, non-invasive nature, and lack of adverse side effects (Poreisz, Boros, Antal & Paulus, 2007). Recently, attention has turned to the idea that tDCS has potential for maintaining cognitive abilities in older adults (Voytek & Gazzaley, 2012). Zimerman et al. (2012) demonstrated that applying tDCS to the motor cortex of older adults greatly enhanced their capacity to acquire a complex motor skill, with the effects lasting for at least a day. The results of this study suggest that enhancing plasticity in older brains can facilitate gains in learning that are comparable to those of their younger counterparts. Other studies focussing exclusively on older adults have revealed that tDCS can improve specific cognitive functions such as object location (Floel et al., 2012) and working memory (Berryhill & Jones, 2012). Previous studies have suggested that neurostimulation methods could play a useful role in multimodal programmes for dealing with problems faced by older adults, such as the use of TMS in combination with motor and cognitive interventions in clinical regimes for reducing the likelihood of falls in older adulthood (Segev-Jacubovski et al., 2011). Voytek and Gazzaley (2012) note that as the population becomes progressively older, it is vital to develop our understanding of the neurobiology of healthy cognitive aging and the ways in which it can be enhanced; tDCS may be particularly promising in this regard.

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Current Study. The current study was developed as a follow-up to a recent investigation which demonstrated that levels of online EA could be improved in healthy older adults by applying anodal tDCS to the right PFC (Harty, Robertson & O’Connell, In Preparation). Using an established Go/No-go paradigm, the Error Awareness Task (Hester et al., 2005), this study found that participants displayed significantly higher levels of online EA when they were receiving real anodal stimulation compared to when they were receiving sham stimulation. This effect was not found when stimulation was applied to the left PFC. The present study aims to complement these findings - and further develop understanding of tDCS polarity by exploring the effects of cathodal stimulation on online EA, while replicating the conditions of the anodal study. Based on the Anodal-Excitatory, Cathodal-Inhibitory tDCS effects that are commonplace throughout the literature, it is hypothesised that cathodal stimulation of the right PFC will impede participants’ online EA, thus they will perform worse on the Error Awareness Task when they are receiving real stimulation compared to when they are receiving sham stimulation. Method Experimental Design and tDCS Protocol. Similar to the anodal study of Harty et al. (In Preparation), a repeated measures design was used to examine the

effects of real and sham cathodal stimulation on older adults’ performance on a task measuring their online EA. A Magstim Eldith DC-stimulator was used to apply tDCS to the right PFC using 2 sponge electrodes (5 x 7cm) that were previously steeped in saline solution. The cathode was placed on the right PFC (F4) and the anode acted as the reference electrode at CZ, according to the international 10-20 system for electrode placement (Jasper, 1958). Participants were blinded to the stimulation type and each took part in two experimental sessions; one in which they received real stimulation (1mA for 7.5 mins, coinciding with the length of each block of the task) and another in which they received sham stimulation (1mA for 30s). Sessions were separated by at least six days, and the order of real and sham sessions was counterbalanced across participants. Participants. Twenty-seven older adults participated in this study. All participants were administered with the Mini-Mental State Examination (MMSE) - a common cognitive screening measure (Folstein, Folstein & McHugh, 1975) - and one participant was deemed ineligible to take part due to their MMSE score falling below the threshold that was considered commensurate with intact cognitive abilities (25). Another participant’s data was excluded due to their sub-standard accuracy on the Error Awareness Task (<30%). The final sample thus consisted of 25 older

Empirical Investigations

ERROR AWARENESS IN HEALTHY OLDER ADULTS adults (16 Female, 9 Male) with a mean age of 69.60 years (SD = 4.13, Range = 6584). During recruitment, participants had been screened for conditions that would render them unsuitable for tDCS, such as neurological/psychiatric illness, substance abuse or metal fragments in the head or neck (Nitsche et al., 2008). All participants had normal or corrected-to-normal vision. In addition, participants were requested to abstain from caffeine on the day of testing. Ethical approval had previously been obtained from the School of Psychology, Trinity College Dublin, and all participants provided written informed consent. Error Awareness Task. The Error Awareness Task (EAT) is a Go/No-go response inhibition task that presents participants with a series of colour words where the congruency of the font colour and the word’s semantic meaning vary across trials (Hester et al., 2005, 2012). When the semantic meaning of the word corresponded to the font that it was written in, participants were required to promptly respond with a left mouse button press (Go trial). Participants were trained to withhold their responses when either of two conditions occurred - when the colour of the word did not match the semantic meaning (Incongruent No-go trial) or when the word was identical to the one occurring on the previous trail (Repeat No-go trial). Commission errors occurred when participants failed to withhold their response for either of these trials, and participants were trained to reg-

ister their awareness of these errors with a right mouse button as soon as possible. This “speeded awareness press” is a recent variation on the EAT and allows insight into the temporal aspects of EA (Murphy, Robertson, Allen, Hester & O’Connell, 2012). Previous studies have demonstrated that participants tend to display higher levels of awareness for incongruent errors than for repeat errors (Hester et al., 2005). A second adaptation to the standard EAT paradigm was introduced by a mechanism that modified the task difficulty relative to the participant’s withholding accuracy (Harty et al., In Press). Performance was measured over periods of 40 trials with the stimulus duration being adapted based on this. Stimuli were initially presented for 750 ms with an inter-stimulus interval (ISI) of 1250 ms. If participants’ accuracy over 40 trials fell between 50 and 60%, this was maintained. When accuracy was above 60%, stimulus duration was decreased to 500ms while ISI became 1500ms. When accuracy was below 50%, stimulus duration was increased to 1000ms and ISI was also set at 1000ms. The task was adjusted in accordance with these rules after every 40 trials. Participants performed five blocks of the task in each of their two sessions; each of these blocks consisted of 225 stimuli (200 go-trials, 12/13 incongruent no-go trials and 12/13 repeat no-go trials) and lasted approximately 7.5 minutes. Stimuli were displayed and controlled using Presentat-

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ion software (Neurobehavioural Systems, Albany, NY, USA) and testing took place in a dimly lit room. Statistical Analysis. Variables analysed from the EAT performance data included general EA, incongruent EA, repeat EA, withholding accuracy, errors of commission and error press reaction time. The three EA scores were calculated by dividing the total number of commission errors by the amount of aware errors, thus these measures represent the percentage of commission errors of which participants were aware. The decision to analyse the error types individually was based on the fact that the improved levels of awareness attributed to the anodal stimulation in the Harty et al. (In Preparation) study were mainly due to improved awareness of repeat errors. All of these variables were analysed using one-way repeated measures ANOVAs to compare the EAT performance of each participant across their real and sham cathodal stimulation sessions. In addition, a one-way between subjects ANOVA was carried out to examine

the effect of gender on differences in EA across real and sham conditions, in order to determine whether gender influenced susceptibility to tDCS. Results Means, standard deviations, and significance levels for the EAT performance data across real and sham cathodal tDCS conditions are presented in Table 1. Overall levels of EA were extremely similar across the two conditions, with EA in the real cathodal condition (M=81.90%) being marginally higher than the sham (M=81.49%). A repeated measures oneway ANOVA revealed that this difference was not statistically significant, F(1,24)=0.04, p=0.84. Analyses were also carried out to identify any potential differential trends in the data on levels of colour EA and repeat EA across real and sham conditions. Reaction times for performing the “error press” did not vary significantly across the two conditions, F(1,24) = 0.02, p> 0.89.

Table 1: EAT Performance Indices across real and sham cathodal stimulation conditions

Empirical Investigations

ERROR AWARENESS IN HEALTHY OLDER ADULTS Differences in awareness of incongruent errors and repeat errors. With regards to incongruent errors, mean levels of awareness were higher when participants were receiving real stimulation (M=94.21, SD=7.35) compared to sham stimulation (M=91.68, SD=9.10), although this difference was not statistically significant, F(1,24)= 2.49, p=0.13. For repeat errors, mean levels of awareness were lower when participants were receiving real stimulation (M=64.81%, SD=16.95) compared to sham stimulation (M=68.07, SD=21.96), but again this difference was not statistically significant, F(1,24) = 0.47, p=0.50. EAT Practice Effects. To investigate the possible role of practice effects on the EAT, levels of awareness were examined across the participantsâ&#x20AC;&#x2122; first and second experimental sessions, regardless of stimulation type. It was found that participants demonstrated slightly higher levels of EA in their first session (M=82.60, SD=9.89) than their second session (M=80.78, SD=9.59), but this difference was not statistically significant, F(1,24)=0.84, p=0.37. However, when the withholding accuracy of participants was examined, as illustrated in Figure 2, it was found that participants performed at a higher level in their second session (M=71.93%, SD=14.34) than in their first session (M=63.48%, SD=13.86) and that this difference was statistically significant, F(1,24)= 19.78, p=0.00. Discussion

The present study was designed to

complement the work of Harty et al. (In Preparation), but ultimately produced unexpected results. The findings of the previous study demonstrated that anodal stimulation of the right PFC improved EA, thus the present hypothesis was that cathodal stimulation over the same area would disimprove it, as per the established conventions of tDCS. This was not the case, as levels of EA were almost identical across real and sham conditions. A noteworthy finding emerged regarding the nature of the practice effect on the EAT task â&#x20AC;&#x201C; participants displayed significantly higher levels of withholding accuracy on their second session, yet practice effects did not extend to their awareness of the errors that they did make. In terms of the overall effect of cathodal stimulation on EA, participants scored slightly higher on average when receiving real rather than sham stimulation. The idea that cathodal stimulation can facilitate, rather than impede, performance on cognitive tasks has received some support in the literature (Weiss & Lavidor, 2012), based on the idea that it can decrease neuronal competition by acting as a noise filter in certain cognitive domains (Antal et al. 2004). However, the improved performance in the cathodal condition was practically negligible and is attributed to chance variation, thus the noise filter hypothesis is insufficient for explaining the current results. It may instead be the case that the Anodal-Excitatory, Cathodal-Inhibitory assumption is more complex than

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previously thought, as argued by Jacobson, Koslowsky and Lavidor, (2012) in a recent meta-analysis. Their qualitative review of the literature suggested that when cognitive functions are modulated using tDCS, anodal stimulation is capable of eliciting sufficient excitation to warrant a significant difference, but cathodal stimulation is less likely to lead to a significant inhibitory response. In fact, most of the studies examining tDCS effects on cognitive-behavioural tasks failed to find the Ae-Ci effect; this was actually found mainly in motor studies. Emerging research continues to question the assumptions regarding tDCS polarity effects by reaffirming that cathodal tDCS does not necessarily lead to inhibition in cognitive tasks (Friederici, Mueller, Sehm & Ragert, 2013). It may also be the case that the stimulation may have differential effects based on the original activation level and neuronal state in the region of interest. Jacobson et al. (2012) posit that anodal stimulation can facilitate neural firing of a region that has previously been activated, thus enabling improved cognitive performance. Conversely, the decrease in neural firing occurring from cathodal stimulation may not be sufficient to significantly impede performance, due to the initial neuronal excitement that results from participants being engaged with the cognitive tasks. These factors could explain the lack of significant effects in this study.

Cognitive functions may be less sus-

ceptible to inhibitory stimulation than motor functions, based on the wider distribution of their neural correlates. Jacobson et al. (2012) make the argument that multiple cognitive regions are involved in the completion of cognitive tasks, therefore any attempts to modulate a single region are less likely to result in cognitive changes compared to attempts to modulate motor functions, which involve fewer regions. Their meta-analysis demonstrated that cognitive functions directly related to language were particularly resistant to the inhibitory effects of cathodal stimulation, due to language being supported by many interconnected brain networks. Because of this, language processing cannot be downgraded by decreasing activity in a single area. Performance in the entire language system can potentially be bolstered by anodal stimulation to just one of the constituent brain regions, but using cathodal stimulation to decrease activity in this region may not be enough to impair performance, as is still supported by the other areas. This theory perhaps best explains the lack of effect found in this study. It has been well established that EA engages other brain areas such as the ACC, therefore downregulating activity in only the PFC may be insufficient to impede EA, even though anodal tDCS can improve it. The practice effect was an interesting finding that emerged from the study; participants displayed significantly higher levels of withholding accuracy in their

Empirical Investigations

ERROR AWARENESS IN HEALTHY OLDER ADULTS second testing session, thus making fewer errors of commission compared to their first session. Although they made fewer errors in the second session, they demonstrated levels of EA comparable to their first session. These results are consistent with a recent study on the plasticity of inhibition in older adults, which demonstrated that retest training can improve their efficiency of inhibition on a Stroop paradigm task (Wilkinson & Yang, 2012). The differential effect of practice on withholding accuracy and EA strengthens the idea that EA is a discrete cognitive function and suggests that it is resistant to the effects of practice. Both this study and the previous study by Harty et al. (In Preparation) focused on the effects of either cathodal or anodal stimulation in isolation, but it may be the case that tDCS effects are optimised when anodal and cathodal stimulation are used in conjunction with each other. Using a Tower of London task, Dockery, Hueckel-Weng, Birbaumer and Plewnia (2009) demonstrated that cathodal tDCS beneficially impacted performance at the initial stage where participants were learning the rules, and anodal tDCS exerted a positive effect at a later stage when participants had become adept at the task. As outlined above, the cathodal stimulation acts to reduce the amount of neuronal noise present as the new cognitive functions are being acquired. These phase-specific effects were sustained over time and the authors suggest that tDCS – when used appropriately – may have the capacity to enable both the gaining of specific planning abil-

ities and their indefinite retention. Future research should continue to move away from the rigid “Anodal-Positive, Cathodal-Negative” dichotomy and examine how the effects can interact. Temporal issues of tDCS-induced performance altering also need clarification, as some research indicates that the effects of tDCS may be strongest when stimulation is applied before the participant actually undertakes a task (Pirulli, Fertonani & Miniussi, In Press). Individual differences in relation to tDCS susceptibility must also be considered, and could partially account for the lack of significant effect in this study. One particular study highlights the profound effect that these individual differences can have, by demonstrating that the facilitative effects of anodal tDCS on working memory in older adults were only present for those with high levels of education (Berryhill & Jones, 2012). The authors speculate that the participants with more education had superior memory strategies, enhancing their ability to recruit PFC structures during memory tasks. It seems that a number of factors may influence an individual’s susceptibility and reactions to neurostimulation, as studies have implicated a number of other variables such as genetic polymorphisms (Cheeran et al., 2008) and personality factors (Peña-Gómez, VidalPeñeiro, Clemente, Pascual-Leone & Bartréz-Faz, 2011). Gender has also been highlighted as a variable that can moderate susceptibility to stimulation (Boggio et al., 2008), but this study found no differences between males and females. This could

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have been due to the uneven gender divide (almost 2:1 in favour of females) and modest sample size. However, one study found that while anodal tDCS lead to significantly higher levels of cortical excitability in women than men, no gender differences in cortical excitability were associated with cathodal stimulation (Chaeib et al., 2008); further strengthening the argument that cathodal tDCS effects are less clear cut than anodal. Ultimately, much is still unknown about the factors influencing the effects of tDCS (particularly in relation to cognitive performance) and thus more research is required to fully utilise its potential and enable its development as a clinical tool. In conclusion, this study did not present findings complementary to those of Harty (2012), but instead contributes to a growing body of research that challenges the convention that cathodal tDCS impedes performance in cognitive tasks. Although the previous study demonstrated that EA can be improved in older adults using anodal stimulation, it is important to ensure that our conceptualisations of EA in the laboratory remain applicable to older adults as they engage in their ADLs. Future studies could attempt to implement neurostimulation on older adults in more ecologically valid settings, as well as investigating the many variables that are still unclear regarding tDCS, particularly if is to be developed as a viable clinical tool that can improve the daily lives of older

adults. References Antal, A., Nitsche, M. A., Kincses, T. Z., Kruse, W., Hoffmann, K. P., & Paulus, W. (2004). Facilitation of visuo-motor learning by transcranial direct current stimulation of the motor and extrastriate visual areas in humans. European Journal of Neuroscience, 19(10), 2888-2892. Band, G. P., & Kok, A. (2000). Age effects on response monitoring in a mental-rotation task. Biological Psychology, 51(2), 201-221. Berkman, E. T., Falk, E. B., & Lieberman, M. D. (2012). Interactive Effects of Three Core Goal Pursuit Processes on Brain Control Systems: Goal Maintenance, Performance Monitoring, and Response Inhibition. PloS one, 7(6), e40334. Berryhill, M. E., & Jones, K. T. (2012). tDCS selectively improves working memory in older adults with more education. Neuroscience Letters, 521(2), 148-151. Bettcher, B. M., & Giovannetti, T. (2009). From cognitive neuroscience to geriatric neuropsychology: What do current conceptualizations of the action error handling process mean for older adults? Neuropsychology Review, 19(1), 64-84.

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ERROR AWARENESS IN HEALTHY OLDER ADULTS Botvinick, M. M., Braver, T. S., Barch, D. M., Carter, C. S., & Cohen, J. D. (2001). Conflict monitoring and cognitive control. Psychological Review, 108(3), 624. Chaieb, L., Antal, A., Paulus, W., Antal, A., Kincses, T. Z., Nitsche, M. A. & Berardelli, A. (2008). Gender-specific modulation of short-term neuroplasticity in the visual cortex induced by transcranial direct current stimulation. Visual Neuroscience, 25(1), 77. Cheeran, B., Talelli, P., Mori, F., Koch, G., Suppa, A., Edwards, M., Houlden, H., Bhatia, H., Greenwood, R. & Rothwell, J. C. (2008). A common polymorphism in the brain-derived neurotrophic factor gene (BDNF) modulates human cortical plasticity and the response to rTMS. The Journal of Physiology, 586(23), 57175725. Cohen, J. D., Botvinick, M., & Carter, C. S. (2000). Anterior cingulate and prefrontal cortex: who’s in control? Nature Neuroscience, 3(5), 421-423. Dockery, C. A., Hueckel-Weng, R., Birbaumer, N., & Plewnia, C. (2009). Enhancement of planning ability by transcranial direct current stimulation. The Journal of Neuroscience, 29(22), 7271-7277. Endrass, T., Schreiber, M., & Kathmann, N. (2012). Speeding up older adults: Age-effects on error processing in speed and accuracy conditions. Biological Psychology, 89(2), 426-432. Festa, E. K., Ott, B. R., Manning, K. J.,

Davis, J. D., & Heindel, W. C. (2013). Effect of cognitive status on self-regulatory driving behavior in older adults: an assessment of naturalistic driving using in-car video recordings. Journal of Geriatric Psychiatry and Neurology, 00(0), 1-9. Flöel, A., Suttorp, W., Kohl, O., Kürten, J., Lohmann, H., Breitenstein, C., & Knecht, S. (2012). Non-invasive brain stimulation improves object-location learning in the elderly. Neurobiology of Aging, 33(8), 1682-1689. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Pergamon Press. Friederici, A. D., Mueller, J. L., Sehm, B., & Ragert, P. (2013). Language Learning without Control: The Role of the PFC. Journal of Cognitive Neuroscience, (Early Access), 1-8. Garavan, H., Ross, T. J., Murphy, K., Roche, R. A. P., & Stein, E. A. (2002). Dissociable executive functions in the dynamic control of behavior: inhibition, error detection, and correction. Neuroimage, 17(4), 1820-1829. Gehring, W. J., & Knights, R. T. (2000). Prefrontal-cingulate interactions in action monitoring. Nature Neuroscience, 3(5), 516-520. Giovannetti, T., Libon, D. J., Buxbaum, L. J., & Schwartz, M. F. (2002). Naturalistic action impairments in dementia. Neuropsychologia, 40(8), 1220-1232.

Student Psychology Journal, Volume IV SHEEHY

Grady, C. (2012). The cognitive neuroscience of ageing. Nature Reviews Neuroscience, 13(7), 491-505.

eration. Electroencephalography and clinical neurophysiology, 10, 371375.

Harty S., Robertson, I. H & O’Connell, (In Preparation). Transcranial direct current stimulation ameliorates awareness deficits in healthy aging.

Javadi Arjomand, A. H. (2011). Memory modulation by offline consolidation and transcranial direct current stimulation (Doctoral dissertation, UCL (University College London)).

Harty, S., O’Connell, R. G., Hester, R. & Robertson, I. H. (In Press). Older Adults Have Diminished Awareness of Errors in the Laboratory and Daily Life. Hester, R., Foxe, J. J., Molholm, S., Shpaner, M., & Garavan, H. (2005). Neural mechanisms involved in error processing: a comparison of errors made with and without awareness. Neuroimage, 27(3), 602-608. Hester, R., Nandam, L. S., O’Connell, R. G., Wagner, J., Strudwick, M., Nathan, P. J., Mattingley, J. B. & Bellgrove, M. A. (2012). Neurochemical enhancement of conscious error awareness. The Journal of Neuroscience, 32(8), 2619-2627. Hoerold, D., Pender, N. P., & Robertson, I. H. (2013). Metacognitive and Online Error Awareness Deficits after Prefrontal Cortex Lesions. Neuropsychologia, 51(3), 385-391. Jacobson, L., Koslowsky, M., & Lavidor, M. (2012). tDCS polarity effects in motor and cognitive domains: a meta-analytical review. Experimental brain research, 216(1), 1-10. Jasper, H. H. (1958). The ten twenty electrode system of the international fed-

Kerns, J. G., Cohen, J. D., MacDonald III, A. W., Cho, R. Y., Stenger, V. A., & Carter, C. S. (2004). Anterior cingulate conflict monitoring and adjustments in control. Science, 303(5660), 1023-1026. Mathalon, D. H., Bennett, A., Askari, N., Gray, E. M., Rosenbloom, M. J., & Ford, J. M. (2003). Response-monitoring dysfunction in aging and Alzheimer’s disease: an event-related potential study. Neurobiology of Aging, 24(5), 675-685. McKinley, R. A., Bridges, N., Walters, C. M., & Nelson, J. (2012). Modulating the brain at work using noninvasive transcranial stimulation. Neuroimage, 59(1), 129-137. Miller, E. K., & Cohen, J. D. (2001). An integrative theory of prefrontal cortex function. Annual Review of Neuroscience, 24(1), 167-202. Murphy, P. R., Robertson, I. H., Allen, D., Hester, R., & O’Connell, R. G. (2012). An electrophysiological signal that precisely tracks the emergence of error awareness. Frontiers in Human Neuroscience, 6.

Empirical Investigations

ERROR AWARENESS IN HEALTHY OLDER ADULTS Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A. & Pascual-Leone, A. (2008). Transcranial direct current stimulation: State of the art 2008. Brain Stimulation, 1(3), 206-223. Nitsche, M. A., & Paulus, W. (2000). Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. The Journal of Physiology, 527(3), 633-639. O’Keefe, F., Dockree, P., Moloney, P., Carton, S., & Robertson, I. H. (2007). Awareness of deficits in traumatic brain injury: A multidimensional approach to assessing metacognitive knowledge and online-awareness. Journal of the International Neuropsychological Society, 13(01), 38-49. Peña-Gómez, C., Vidal-Piñeiro, D., Clemente, I. C., Pascual-Leone, Á., & Bartrés-Faz, D. (2011). Down-regulation of negative emotional processing by transcranial direct current stimulation: effects of personality characteristics. PloS one, 6(7), e22812. Peruzzotti-Jametti, L., Bacigaluppi, M., Sandrone, S., & Cambiaghi, M. (2013). Emerging subspecialties in Neurology Transcranial stimulation. Neurology, 80(4), 33-35. Pietschmann, M., Endrass, T., & Kathmann, N. (2011). Age-related alterations in performance monitoring during and after learning. Neurobiology of Aging, 32(7), 1320-1330. Pirulli, C., Fertonani, A., & Miniussi, C.

(In Press, Corrected Proof). The role of timing in the induction of neuromodulation in perceptual learning by transcranial electric stimulation. Brain stimulation. Poreisz, C., Boros, K., Antal, A., & Paulus, W. (2007). Safety aspects of transcranial direct current stimulation concerning healthy subjects and patients. Brain Research Bulletin, 72(4), 208214. Ridderinkhof, K. R., Ullsperger, M., Crone, E. A., & Nieuwenhuis, S. (2004). The role of the medial frontal cortex in cognitive control. Science Signalling, 306(5695), 443. Segev-Jacubovski, O., Herman, T., Yogev-Seligmann, G., Mirelman, A., Giladi, N., & Hausdorff, J. M. (2011). The interplay between gait, falls and cognition: can cognitive therapy reduce fall risk? Expert Review of Neurotherapeutics, 11(7), 1057-1075. Simons, R. F. (2009). The way of our errors: theme and variations. Psychophysiology, 47(1), 1-14. Suchy, Y., Kraybill, M. L., & Franchow, E. (2011). Instrumental activities of daily living among community-dwelling older adults: Discrepancies between self-report and performance are mediated by cognitive reserve. Journal of Clinical and Experimental Neuropsychology, 33(1), 92-100. . Toglia, J., & Kirk, U. (2000). Understanding awareness deficits following brain injury. NeuroRehabilitation-An Interdisciplinary Journal, 15(1), 57-70.

Student Psychology Journal, Volume IV SHEEHY

Tseng, P., Hsu, T. Y., Chang, C. F., Tzeng, O. J., Hung, D. L., Muggleton, N. G., Walsh, V., Liang, W. K, Cheng, S.K. & Juan, C. H. (2012). Unleashing potential: transcranial direct current stimulation over the right posterior parietal cortex improves change detection in low-performing individuals. The Journal of Neuroscience, 32(31), 10554-10561. Voytek, B., & Gazzaley, A. (2012). Stimulating the aging brain. Annals of Neurology, 73(1), 1-3. Weiss, M., & Lavidor, M. (2012). When less is more: evidence for a facilitative cathodal tDCS effect in attentional abilities. Journal of Cognitive Neuroscience, 24(9), 1826-1833. Wilkinson, A. J., & Yang, L. (2012). Plasticity of inhibition in older adults: Retest practice and transfer effects. Psychology and Aging, 27(3), 606. Yeung, N., & Summerfield, C. (2012). Metacognition in human decision-making: confidence and error monitoring. Philosophical Transactions of the Royal Society B: Biological Sciences, 367(1594), 1310-1321. Zimerman, M., Heise, K. F., Hoppe, J., Cohen, L. G., Gerloff, C., & Hummel, F. C. (2012). Modulation of training by single-session transcranial direct current stimulation to the intact motor cortex enhances motor skill acquisition of the paretic hand. Stroke, 43(8), 2185-2191.

Student Psychology Journal, 2013, 87-105

An Investigation of Moral Development: the Effect of Religiosity on Kohlbergian Moral Reasoning Meg Stapleton Trinity College, Dublin Correspondence: stapleme@tcd.ie

abstract

The relationship between religious faith and moral reasoning was examined. The hypotheses that those who identify as non-religious will display different levels of moral reasoning to those who identify as religious were investigated. Of the religious sample, education, gender, strength and type of religion were assessed in relation to predicting postconventional moral reasoning. One hundred and ten participants currently in third level education completed Restâ&#x20AC;&#x2122;s Defining Issues Test, the Revised Religious Life Inventory, and The Santa Clara Strength of Religious Faith Questionnaire as part of an online survey. An independent-samples t-test showed a significant difference between principled morality scores between religious and non-religious participants (t(108) = -2.12, p = .04). A hierarchical multiple regression was carried out on the religious sample (N = 50). The overall model was significant (F (6, 43) = 4.83, p < .001. R2 = .40, Adj R2 = .32). Quest religiosity was a significant predictor of postconventional moral reasoning. Other variables did not significantly predict any of the variance. Both principle hypotheses were supported. Results are discussed in with reference to methodological flaws and future recommendations.

Student Psychology Journal, Volume IV STAPLETON Introduction

Increasing debate around the role of religion in society has led to attempts to identify its merits in relation to matters of both commonwealth and the individual. Psychology can contribute to this debate by providing insights into elements of religiosity that may affect cognitions such as decision-making and considerations of social convention. This study aims to address issues of religion in relation to moral reasoning based on previous psychological investigation. Moral reasoning can be considered as the process by which an individual makes a judgment of a situation based on the ethical principles that they hold. The decision can be shaped by numerous factors across a lifetime and is subject to influence from both the individual and wider culture. Moral reasoning was initially grounded in theory by Jean Piaget who identified two stages of moral development (Crain, 1985). However, the theoretical framework of moral reasoning remains topical, with new challenges and models frequently proposed. This study will focus on the theory of moral development as proposed by Lawrence Kohlberg in the mid-20th century (Crain, 1985) and the most psychologically applicable aspects of its principles today.

Expanding on the work of Piaget,

Kohlberg proposed a more detailed model for moral development. Within the Kohlbergian tradition, moral reasoning is defined as the individualâ&#x20AC;&#x2122;s socio-moral perspective, the characteristic point of view from which a person formulates moral judgments (Rest, Thoma, Navaez and Bebeau, 1997). The theory states that moral development is a universal process that develops in stages of ordered acquisition and with a lack of reversal. Kohlberg put forward three levels of development, each with two sub-stages, as part of his theory (1969). Each level identifies a different stage of morality: (i) Level one is referred to as preconventional morality. Within this level social norms are either not understood or ignored and as such fail to enter into the moral reasoning process. In general the strategies of this level are based on avoiding punishment (stage one) and satisfying oneâ&#x20AC;&#x2122;s needs (stage two). (ii) Level two is conventional morality. Social norms, rules, and roles are considered as part of moral reasoning within this level. This level centres on acknowledgment and respect of authorities, rules and convention. The focus of this level is being a good person (stage three) and maintaining social order (stage four). (iii) Level three is postconventional morality, also known as principled moral reasoning. The most complex level, post-

Empirical Investigations

MORAL REASONING AND RELIGIOSITY conventional reasoning entails independent thinking. This level is not based upon social norms but on individual moral principles. Alternatives to the law when it is seen as being at odds with social convention (stage five) are considered at this stage. Abstract ethical principles are also addressed at this level (stage six). When conventions and principles conflict, postconventional reasoning will be based upon a personâ&#x20AC;&#x2122;s own moral evaluation of a situation over social conventions (Duriez and Soenens, 2006). According to Kohlberg, the nature of moral instruction (e.g. early exposure to socio-moral conflicts) can enhance or hinder moral development but the course of development should be universally the same in all socio-cultural contexts (Kohlberg, 1969). It is hypothesised that moral behaviour is more consistent and predictable at the higher stages because the stages themselves employ increasingly more stable standards (Kohlberg, 1976). The majority of research suggests that level one is completed by most by early adolescence and level two by late adolescence through to adulthood (Rest, Thoma, Navaez and Bebeau, 2000). Debate remains over attainment of the third level of moral reasoning. Some research suggests that the postconventional level of moral reasoning will be achieved by mid adulthood, while others propose some may never reach this level (Colby

and Kohlberg, 1987). Longitudinal evidence supports the theory of ordered acquisition and lack of reversals as proposed by Kohlberg (Dawson, 2002). Both Kohlbergâ&#x20AC;&#x2122;s original longitudinal study of New England schoolboys (Colby and Kohlberg, 1987) and various other research such as a longitudinal study of Israeli kibbutz residents (Snarey, Reimer and Kohlberg, 1985), and country dwelling Turkish children (Nisan and Kohlberg, 1982) support this sequential theory. It is proposed that the postconventional level of moral reasoning reflects the highest level of moral maturity that can be attained (Colby and Kohlberg, 1987). Research has indicated that this level of moral reasoning may be particularly sensitive to particular factors. This study will address some of these variables and their relationship with the postconventional level of moral reasoning. Religiosity. Kohlberg denied that religion had any effect on moral development. He proposed that religiosity and moral reasoning are two separate processes where the former is based upon revelations by religious authority and the latter is grounded in rational arguments of justice. These arguments are said to be influenced by higher levels of cognitive development and exposure to sociomoral experiences and debate, such as in higher education (Kohlberg, 1981). Likewise, in an early cross-cultural study of various religions

Student Psychology Journal, Volume IV STAPLETON

none differed on levels of moral development (Kohlberg, 1967). However, research has pointed to evidence of a relationship between moral development and aspects of religiosity, including the type and strength of religion involved (Wahrman, 1981). Allport (1954) first distinguished types of religious faith in the mid-part of the 20th century in which he identified an intrinsic and an extrinsic orientation of faith. Intrinsic religiosity has been described as being the supreme value, in which religion is the motive itself. Faith is internalised and followed as closely as possible (Ji, 2004). Extrinsic religiosity is characterised as instrumental and self-serving, in which religion is used as a social means to acquire security and self-justification (Shee, Ji and Boyatt, 2002). It has been reported those who are extrinsically orientated have a tendency to conform to authority and support what is believed to be â&#x20AC;&#x2DC;normalâ&#x20AC;&#x2122; for social approval (Ji and Suh, 2008). This model of religiosity was later modified to include a third construct. Batson and colleagues added a dimension labelled as quest in order to create a multidimensional model of religiosity (Batson, Schoenrade, and Ventis, 1993). Quest religiosity has been defined as an open-ended, questioning approach to religion, one more interested in the on-going quest for truth than simple answers (Ji, 2004). Those

who exhibit a preference for the quest dimension are believed to be predisposed to think in less rigid and more complex ways about various issues and to have lower levels of tolerance for social conventions (Ji and Suh, 2008). Based on this theory, it was proposed that the distinctions between the extrinsic-intrinsic constructs are comparable to those between Kohlbergâ&#x20AC;&#x2122;s conventional and postconventional levels of moral reasoning (Ernsberger and Manaster, 1981). Although those with religious affiliations have been reported to display decreased preference for postconventional reasoning (Deka and Broota, 1988), it may be the type of religious orientation that dictates the cognitions involved rather than religion itself. Previous research has investigated the link between the three different types of religiosity (intrinsic, extrinsic, and quest) and moral reasoning. Some research has indicated that those who identify themselves as having religious traits or commitment often lag behind non-religious people in terms of progressing to the postconventional level of moral reasoning (Glover, 1997). In a college student sample, Sapp and colleagues found an inverse relationship between intrinsic religiosity and principled moral reasoning (Sapp and Gladding, 1989; Sapp and Jones 1986). Additionally, the quest scale was noted in particular as being associated with the pos-

Empirical Investigations

MORAL REASONING AND RELIGIOSITY tconventional level of moral development. The authors suggested that those with high levels of quest religiosity might use differentiated mental processes when dealing with moral issues (Sapp and Jones, 1986). Those who feel driven to question their own faith are thought to be more likely to display principled moral reasoning (Batson et al, 1993). However, research carried out by Ji found that both intrinsic and quest orientations increase the likelihood of exhibiting postconventional reasoning (2004). In an investigation into a solely Islam sample there was evidence that intrinsic religiosity was positively related to principled moral reasoning (Ji, Ibrahim and Kim, 2009). In the same study those who attended congregational worship were linked with the lower conventional level of moral reasoning, as were those who practice for personal benefits, i.e. extrinsically-orientated. Research appears to support the idea that the quest dimension is positively related to postconventional reasoning (Glover, 1997) and extrinsic negatively related (Ji et al, 2009). However, debate remains over the influence of intrinsic religiosity on moral reasoning, with conflicting data on the direction of the relationship (Sapp and Gladding 1989; Ji, 2004).

Factors that may impact the relationship between religious faith and level of moral reasoning. The strength of an individualâ&#x20AC;&#x2122;s religion may have an impact on

the type of moral reasoning they exhibit, particularly when considered in tandem with the type of religious dimension they display. Ernsberger and Manaster have argued that the moral reasoning employed by religious individuals depends on the seriousness of their religious commitment (1981). The strength of oneâ&#x20AC;&#x2122;s religiosity has been simply classified as ranging from high, medium or low (Plante and Boccacini, 1997). However, little research has been carried out in relation to this aspect of religion and moral reasoning. Strong correlations have been found between levels of education and the level of moral reasoning reached. Kohlberg posited that moral development is encouraged through direct and repeated experiences with moral conflicts in social contexts (Kohlberg, 1969). A common arena for these experiences is that of formal education, particularly at the higher levels of college and university. Research has suggested strong positive relationships between educational attainment and the level of moral development procured (Rest, 1993). Some have suggested that Kohlbergâ&#x20AC;&#x2122;s model may be gender biased. Gilligan suggested that women base moral decisions on different types of reasoning than men (1982). The initial investigations into the Kohlbergian model were carried out with male samples. This gender bias may have resulted in an androcentric model. Howev-

Student Psychology Journal, Volume IV STAPLETON

er, later research appears to refute a significant gender difference in moral reasoning with evidence suggesting only slight differences between male and female samples (Jaffee and Hyde, 2000; Ji, 2004). More recent research in moral psychology has challenged the Kohlbergian paradigm with the suggestion that morality may take some form of intuition and are both innate and learned (Haidt and Joseph, 2004). This theory of intuition opposes the concept of reasoning as outlined above and instead incorporates a greater role of affective response (Cushman, Young and Greene, 2010). Similarly, Moral Foundations Theory proposes five psychological foundations of morality, presented as two individualising foundations – Harm and Fairness; accompanied by three binding foundations – Purity, Loyalty, and Authority (Haidt and Joseph, 2004). Theoretical parallels between the levels of moral reasoning as proposed by Kohlberg and the moral foundations as set by Haidt and colleagues have been suggested (Graham and Haidt, 2010). However, empirical evidence has been found lacking in this area (Baril and Wright, 2012), providing the stage theory of moral development with more support. The current study will consider religious faith in relation to postconventional moral reasoning. Similarly, education, gender, strength and type of religion in relation to principled moral reasoning will

be assessed. Moral reasoning will be measured using Rest’s Defining Issues Test [DIT-1, short form] (Rest, 1979). The DIT stands as the most researched and validated objective measure of moral judgement (Glover, 1997). Levels of religiosity will be measured using the Revised Religious Life Inventory (RLI; Hills, Francis and Robbins, 2004). This instrument was selected as it has been successfully used in previous studies and is applicable to many religious affiliations (Hills, Francis, Argyke and Jackson, 2004). The strength of religiosity will be ascertained using the Santa Clara Strength of Religious Faith Questionnaire (SCSORF; Plante and Boccaccini, 1997). This is a simple yet effective measure of an individual’s strength of religion, regardless of religious denomination (Plante, Vallaeys, Sherman and Watson, 2002). Hypotheses. Based on the findings to date and the literature reviewed, this study will focus on the relationship between a person’s type of religiosity and their level of moral reasoning. The principle hypotheses are: i) Those who identify as non-religious will display different levels of moral reasoning than those who identify as religious

Empirical Investigations

MORAL REASONING AND RELIGIOSITY ii) In a religious sample, differences between individual’s strength of religion; type of religious faith; gender, and education will predict different levels of moral reasoning

(47.3%) participants had completed the Leaving Certificate, 34 (30.9%) an Undergraduate degree, and 22 (20%) a Master’s degree or equivalent. All participants were currently enrolled in third level education.

Method

The most popular response for religious affiliation was ‘None’, selected by 52 participants (47.3%), followed by Roman Catholic (40.9%). For a full summary of demographic findings see Appendix B.

Design. Part 1. A within-groups design was used. All participants completed the survey in which the independent variable for H1 was religious belief. The principled morality score was the dependent variable. An a-priori power analysis indication that for H1 102 participants were required to achieve a medium effect size with p<.05. It was expected that P-scores would differ for religious and non-religious participants. Part 2. The predictor variables for H2 were gender, education, strength and type of religiosity. The criterion variable was the principled morality score of each participant. An a-priori power analysis indication that for H2 97 participants were required to achieve a medium effect size with p<.05. It was expected that one or more of the above variables could predict differences in P-scores amongst a religious sample. Participants. One hundred and ten participants took part in this study of which 37 (33.6%) were male and 73 (66.4%) were female. Participant ages ranged from 18-49 (Mean=22.6, SD=4.1). Fifty-two

Participants were recruited through both the researcher’s contacts and through the School of Psychology at Trinity College, Dublin. Psychology students at Trinity College participated in exchange for research credits. First and second year students received two research credits for their participation. All other participants operated on a voluntary basis. Measures. (i) Rest’s Defining Issues Test (Rest, 1979) is an instrument designed to assess stages of moral development as based on Kohlberg’s model. The three item short form was used in this study. This version of the test retains high levels of validity and reliability while taking less time to complete The three stories on the short form were selected based on their having the highest correlation of any 3 stories with the full 6 story set, with the P-score from the short version found to correlate .93 with the P-score of the 6 story version

Student Psychology Journal, Volume IV STAPLETON

(Rest, 1986). The DIT short form consists of reading three moral dilemmas followed by rating twelve short issue statements based on each scenario. These items are rated in terms of importance on a fivepoint scale, ranging from great importance to none. Following this the twelve items are considered as a set and the four highest rated items are then ranked in order of importance. From these four rankings a P-score (principled morality score) is

calculated based on the relative importance given to items representing stages 5 and 6, the postconventional level of moral reasoning (Rest and Navarez, 1994). The P-score ranges from 0 to 95 and represents a percentage. A higher score indicates higher moral judgment development (Rest, 1993). Rest puts forward the following examples of normative P-scores based on longitudinal research (1993):

Table 1:Normative P-scores and stage of education

P-score range

Education range

30 – 40 40 – 50 50 – 60 60 + morality*

High School/Pre-College College undergraduate College postgraduate College postgrad studying

*Students undertaking study in areas such as Philosophy, Psychology etc.

(ii) The Revised Religious Life Inventory (Hills, Francis and Robbins, 2004) was used to measure type of religiosity. It is a 24-item survey that is a shortened version of Batson and Schoenrade’s original 32-item Religious Life Inventory (1991). This instrument uses a nine-point scale ranging from “strongly agree” to “strongly disagree” in order to assess an individual’s levels of intrinsic, extrinsic and quest religiosity. The elimination of unreliable items from the original measure resulted in stronger internal consistency (0.83 in the Revised RLI versus 0.77 in the original) and Cronbach’s alpha remained the

same for both at 0.93 (Hills, Francis and Robbins, 2004). The simplified method of scoring for this scale was employed with standard scores for each scale calculated by subtracting the mean for each scale from each participant’s mean score then dividing the remainder by the standard deviation for that scale (Batson, Schoenrade, & Ventis, 1993, p. 176). (iii) The Santa Clara Strength of Religious Faith Questionnaire (Plante and Boccaccini, 1997) is a 10-item measure designed to assess an individual’s strength of religiosity, regardless of religious

Empirical Investigations

MORAL REASONING AND RELIGIOSITY denomination. The scale uses a 4-point Likert scale ranging from “strongly disagr-ee” to “strongly agree”. Scores can range from 10 to 40 with higher aggregates representing stronger religious faith. The scale has been found to be internally consistent, with an alpha coefficient of .93 (Lewis, Shevlin, McGuckin and Navratil, 2001). It is an effective measure of an individual’s strength of religiosity regardless of religious denomination (Plante et al., 2002). (iv) A short demographic questionnaire was also used as part of this study. Participants were required to identify their gender and age. To ascertain level of education each participant had to identify the level completed up to the time of testing. Finally, participants identified their religious affiliation. Procedure. Ethical approval for this study was granted in January 2013 by the ethical review board of the School of Psychology, TCD. The survey was carried out online. Participants were provided with the link to the study via email. Upon opening the link, they were redirected to the SurveyMonkey questionnaire platform. Before the study began, a consent form providing information on the study and instructions for proceeding was presented. Participants provided consent by reading this form and clicking on ‘Next’ and proceeding to the demographic questionnaire.

Part One. Following the completion of the demographic questionnaire, religious and non-religious individuals (N = 110) completed Rest’s Defining Issues Test. Part Two. Participants also completed the Revised Religious Life Inventory followed by The Santa Clara Strength of Religious Faith Questionnaire. However, only the data attained from the religious sample (N =50) was utilised in the analysis of this data as it pertained to the second hypothesis. Participants completed the survey by following the instructions provided for each section. All questions were mandatory. Participants could take as much time as they wished to complete the survey, and could return to complete unfinished questions at their leisure. Upon completion of the survey, participants viewed a debriefing form that clarified the purpose of the study and provided appropriate contact information for those who required it. Results i) H1 –Those who identify as non-religious will display different levels of moral reasoning than those who identify as religious. An independent-samples t-test was conducted to evaluate the hypothesis that those with religious faith will display low-

Student Psychology Journal, Volume IV STAPLETON

er principled morality scores than those who are not religious. The independent variable was religion and the dependentvariable was participantâ&#x20AC;&#x2122;s P-scores. All parametric assumptions were met. Leveneâ&#x20AC;&#x2122;s test for equality of variances was not significant (F = 2.7, p = .10), ensuring homogeneity of variance. Results showed there was a significant difference between P-scores between religious and non-religious participants (t(108) = -2.12, p = .04). Principled morality scores of religious participants (M = 38.1, SD = 15.2) on average were lower than non-religious participants (M = 45.1, SD = 18.7).

Figure 1. Mean P-scores for religious and non-religious participants

ii) H2 - In a religious sample, differences between individualâ&#x20AC;&#x2122;s strength of religion; type of religious faith; gender, and education will predict different levels of moral reasoning. A hierarchical multiple regression was employed to evaluate

whether gender, education, strength of religion and type of religiosity predicted principled morality scores. Gender and education were controlled for in Step 1, strength of religion in Step 2, and types of religiosity were all entered in Step 3. The overall model was significant (F (6, 43) = 4.83, p < .001. R2 = .40, Adj R2 = .32). Gender and education did not significantly predict any of the variance (F(2, 47) = 2.72, p = .08, R2 = .10, Adj R2 = .06). In step 2 religious strength scores were entered into the regression equation. The change of variance accounted for (R2) was .16 and the overall step did not significantly predict any of the variance (F (1, 46) = 3.22, p = .08). Type of religiosity (extrinsic, intrinsic and quest) accounted for 40% of the variance in principled morality scores in this sample (F (3, 43) = 5.78, p = .002, R2 = .40, Adj R2 = .32). Quest religiosity was a significant predictor of P-scores ( = .50, p < .001). Extrinsic ( = .01, p = .96) and intrinsic religiosity ( = .01, p = .60) did not significantly account for any of the variance.

Empirical Investigations

MORAL REASONING AND RELIGIOSITY was found to be statistically significant and in line with previous research (Glover, 1997). Likewise, these results appear to refute Kohlbergâ&#x20AC;&#x2122;s original claim that religion shows no correlation with moral development (Kohlberg, 1967). The second hypothesis considered the religious sample and what elements of religiosity would predict moral reasoning. Based on previous research, the role of gender, education, strength of religion and type of religion (extrinsic, intrinsic and

Discussion Both principle hypotheses of this study were confirmed. Religious participants were less likely to display postconventional moral reasoning. Results indicated that participants who identify as religious displayed lower principled morality scores than those who identify as non-religious. This difference

quest) were all assessed as possible predictors in this model. The overall model was significant. Quest religiosity was found to make significant contributions to predicting principled moral reasoning amongst participants. In contrast, there was little evidence to show significant links between postconventional reasoning and the other religiosity variables. Extrinsic and intrinsic religiosity did not make significant contributions, nor did religious strength. These results appear to support the literat-

Student Psychology Journal, Volume IV STAPLETON

re that points to quest religiosity as the strongest associate with postconventional moral reasoning amongst religious samples (Sapp and Jones, 1986). The other factors explored in this study were not found to be significant predictors of postconventional reasoning. The significant difference in P-scores amongst religious and non-religious participants could be explained by decision-making processes as suggested by previous investigations and theory. Research suggests religious people are more likely to prefer order, traditions and conformity in their lives, as well as displaying a tendency to base decisions on expectations of authority figures (Duriez, 2004). This may explain lower principled morality scores among this cohort as in line with Kohlbergâ&#x20AC;&#x2122;s stages of moral development. Adherence to authority and social norms is indicative of the conventional level of reasoning according to Kohlbergâ&#x20AC;&#x2122;s theoretical framework, thereby resulting in diminished P-scores. It is important to note that this is not to suggest that religious people hold prejudiced attitudes or lack empathy, rather they may simply employ different methods of decision-making based on their faith. Although they may exhibit greater levels of conservatism than non-religious people this does not correspond with a greater lack of tolerance overall (Duriez, 2004). Of the religious sample, quest religiosity was found to be a significant predic-

tor of postconventional moral reasoning. As mentioned previously those of quest religiosity are thought to be predisposed to think in less rigid ways when dealing with social issues (Ji and Suh, 2008). Similarly, they are seen to display lower levels of tolerance for social conventions and norms, a hallmark of postconventional reasoning exhibited in Kohlbergâ&#x20AC;&#x2122;s higher stages (Batson et al, 1993). This stands in contrast to those who hold an extrinsic dimension to their religious faith. Extrinsic religiosity is believed to be adhered to by those who seek social and institutional approval and favour, again a hallmark of the conventional stages (Vainio, 2011). Intrinsic religiosity was not seen to predict postconventional moral reasoning in this study. This appears to follow the line of Sapp and colleagues who reported an inverse relationship between intrinsic religiosity and the postconventional levels (Sapp and Gladding, 1989). A possible explanation for this may rest with the description of the intrinsic dimension as being internalised and followed as closely as possible (Ji, 2004). Depending on the doctrine of a particular religion this may affect the reasoning employed by an individual. Research has found that some religious believers justify moral choices by references to divinity-based concepts (Jensen, 1997). Religious strength did not predict P-scores. Strength of religion appeared to be correlated with extrinsic and intrinsic

Empirical Investigations

MORAL REASONING AND RELIGIOSITY religiosity. This may be explained by both the internalising aspect of religion displayed by intrinsic religiosity as well as the possible desire to appear religious as seen with extrinsic religiosity (Ji, 2004). This element of religiosity has not been thoroughly examined in relation to moral reasoning. It would appear type of religion exerts much stronger influence over the interpretation and solving of moral dilemmas than possession of strong faith. Future research would benefit from more stringent investigation into this area. Analysis of the different types of religiosity grouped by strength of faith could provide another dimension to the relationship between religion and moral development. It has been noted that higher education can provide contexts and practices that encourage students to engage divergent perspectives when approaching problems or issues and this can be conducive to moral reasoning growth (Mayhew, Seifert and Pascarella, 2010). Rest identifies the college years as the time when postconventional reasoning is most salient and most crucial for moving individuals beyond conventional moral thinking (Rest, 1980). Likewise, evidence suggests that those of postgraduate level of education are more likely to exhibit postconventional reasoning over those of undergraduate level (Rest, 1986). It is thought that this stage of education contains greater exposure to social issues and requires a development of higher levels of abstract and analytical reasoning (Ji, 2004). This could make

individuals at this level more sensitive to moral issues and more likely to question social norms and rules. This sample consisted of university students in order to account for educational levels based on previous theory, as well as to correspond with expected age ranges of late adolescence/early adulthood identified as being correlated with postconventional reasoning (Rest el al, 2000). In the religious sample education level did not emerge as a predictor of P-scores. Future studies should consider using a more diverse sample in order to test whether levels of education impact P-scores. With reference to the current study, it may be interesting to examine the role of education as a potential mediator in the relationship between morality scores and type of religious faith. Gender was not found to be a significant predictor of moral reasoning in the religious sample of this study. Gilligan proposed that women base moral decisions on different types of reasoning than men (1982). It was concluded that women rarely reached postconventional levels of moral reasoning and most often remained at the conventional stages, those of helping and pleasing (Gilligan, 1982). She theorised a â&#x20AC;&#x2DC;morality of careâ&#x20AC;&#x2122;, one considered as a separate moral orientation. The makeup of the sample was rather homogenous with over 66% of participants being female which may have resulted in a gender bias. In order to explore Gilliganâ&#x20AC;&#x2122;s asserti-

100 Student Psychology Journal, Volume IV STAPLETON ons, future studies should ensure an equally balanced sample. The findings indicated that gender and education scores may have been approaching significance as predictors for moral reasoning. However, it is unclear as to whether these findings were indicative of an actual difference in moral reasoning between these groups, or if it was skewed by a sampling error. Future replications of this study should incorporate a larger number of participants that includes a more heterogeneous sample in terms of gender, as well as level and discipline of education, in order to avoid confounding the results. Furthermore, achieving a more diverse sample may have provided insight into differences in moral reasoning amongst different religions. Limitations and Future Studies. The current study contained a number of limitations that should be considered when interpreting the results: The small sample size may have diminished the robustness of the results. Due to time constraints the religious sample (N = 50) was too small for the regression analysis. As such, these results must be taken with caution. The area of study may affect studentâ&#x20AC;&#x2122;s moral development (Moon, 1986). As such, the participantâ&#x20AC;&#x2122;s discipline of study may have accounted for certain moral reasoning processes. Similarly, psycholo-

gy students have been reported to obtain higher morality scores than other students (Cesur, 1997; Bernardi et al, 2004). Given that a portion of the sample was psychology students completing in exchange for research credits, this may have had an effect on P-scores. Social desirability may have influenced participantâ&#x20AC;&#x2122;s responses to an extent. Measures of religiosity have been found to be particularly sensitive to response bias, with participants found to over-report their actual participation in religious services and other activities (Presser and Stinson, 1996). Likewise, studies involving moral dilemmas have been found to be particularly sensitive to social desirability (Reynolds and Ceranic, 2007). However, the online and anonymous nature of this study may have controlled for this effect. The online setting of the study provided an efficient method of survey dissemination and analysis. However, this approach renders controlling for distraction and attention impossible. Participants were able to leave and return to the survey as often as they wished which may have influenced responses. Future replications may benefit from an exploratory setting in order to maintain concentration and attention. Future studies may wish to focus on the quest element in relation to moral reasoning. The quest dimension in this study cored higher in morality than other eleme-

Empirical Investigations

101

MORAL REASONING AND RELIGIOSITY nts of religiosity, but the non-religious sample scored higher than the religious overall. Comparing an all-quest sample to a non-religious sample may provide insight into whether those of religious faith who question their doctrine might score differently from those without faith. Furthermore, an additional suggestion for future investigation is an analysis of the effects of different types of religiosity on different levels of moral reasoning, such as whether there exist greater effects of extrinsic/intrinsic religiosity on conventional reasoning, etc. The literature on moral reasoning appears to highlight that moral education can be shaped in many ways such as through formal education, religious beliefs, and familial and social interactions. This is something to consider when investigating ways to encourage moral development. Research has found that schools who have some form of moral education separate from religious education resulted in students with higher P-scores than in schools where moral consideration was gained from religious classes alone (Vainio, 2011). Future research could consider the merits of secular moral education in schools that also provide religious instruction. Conclusion Overall the results of this study suggest that it may be a construct of religiosity, but not religiosity itself, that influences

moral reasoning. The type of religiosity displayed by an individual might be the greatest indicator of the level of moral reasoning they are most likely to utilise. Understanding moral development is important as it is a process shaped by numerous factors such as society, education and personal life experiences. Early stages are imposed and shaped by social norms. It is later in life when different frameworks emerge that will govern decisions of a moral nature. However, it is important to note that the theory dealt with in this study is merely one approach. A frequent criticism of the Kohlbergian construct is its appointment of postconventional reasoning as being the pinnacle of moral development and as such being developmentally superior. Other approaches, such as that taken by Moral Foundations Theory, should be considered and further applied to research in this domain. With an increasingly secular and questioning society the role of religion is of interest in identifying changes in moral reasoning. In light of these findings, one could further question the role of religious faith in moral development. It may be a case that a particular style of religious belief can influence moral reasoning. Future study should examine the role of the quest element of religion in particular, as it could be considered to promote moral development. In turn, further research could investigate the factors that result in differences in moral reasoning in religious subtypes and in the non-religious. Overall the find-

102 Student Psychology Journal, Volume IV STAPLETON ings of this study suggest that it is necessary to explore the idiosyncrasies of religious faith, rather than looking at religion as a complete structure in itself. It may not be a case of the amount of faith one possesses with an all or none approach, but rather a question of type. References Allport, G. W. (1954). The Nature of Prejudice. Cambridge, MA: Perseus Books. Baril, G. L., & Wright, J. C. (2012). Different types of moral cognition: Moral stages versus moral foundations. Personality and Individual Differences, 53(4), 468-473. Batson, C.D. & Schoenrade, P. (1991). Measuring religion as quest. 1) Validity concerns. Journal for the Scientific Study of Religion, 30, 416-429. Batson, C. D., Schoenrade, P., & Ventis, W. L. (1993). Religion and the Individual. New York: Oxford University Press. Bernardi, R. A., Metzger, R. L., Bruno, R. G. S., Hoogkomp, M. A. W., Reyes, L. E., & Barnaby, G. H. (2004). Examining the decision process of students’ cheating behavior: An empirical study. Journal of Business Ethics, 50, 397-414. Cesur, S. (1997). The relationship between cognitive and moral development. Yayinlanmamis yüksek lisans tezi, Bogaziçi Üniversitesi, Sosyal Bilimler Enstitüsü, Istanbul.

Colby, A. & Kohlberg, L. (1987). The Measurement of Moral Judgment Vol. 2: Standard Issue Scoring Manual. Cambridge University Press. Crain, W.C. (1985). Theories of Development. Prentice-Hall. Dawson, T.L. (2002). New tools, new insights: Kohlberg’s moral judgement stages revisited. International Journal of Behavioral Development, 26 (2), 154-166. Cushman, F., Young, L., & Greene, J. D. (2010). Our multi-system moral psychology: Towards a consensus view. The Oxford handbook of moral psychology, 47-71. Deka, N., & Broota, K.D. (1988). Relation between level of religiosity and principled moral judgment among four religious communities in India. Journal of Personality and Clinical Studies, 4, 151–156. Duriez, B. (2004). A research note on the relation between religiosity and racism: The importance of the way in which religious contents are being processed. The International Journal for the Psychology of Religion, 14, 175-189. Dureiz, B. & Soenens, B. (2006). Religiosity, moral attitudes and moral competence: A critical investigation of the religiosity-morality relation. International Journal of Behavioral Development, 31, 75 – 82.

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MORAL REASONING AND RELIGIOSITY Ernsberger, D. J., & Manaster, G. J. (1981). Moral development, intrinsic/ extrinsic religious orientation and denominational teaching. Genetic Psychology Monograph, 104, 23-41.

Jensen, L. (1997). Different world views, different morals. Human Development, 40, 325-344.

Gilligan, C. (1982). In a different voice. Cambridge, MA, Harvard University Press.

Ji, C. C. (2004). Religious Orientations in Moral Development. Journal Of Psychology & Christianity, 23(1), 22-30.

Glover, R. J. (1997). Relationships in moral reasoning and religion among members of conservative, moderate, and liberal religious groups. The Journal Of Social Psychology, 137(2), 247-255.

Ji, C. C., & Suh, K. (2008). Doctrinal faith and religious orientations in rightwing authoritarianism: A pilot study of American and Korean Protestant college students. Journal Of Psychology And Christianity, 27(3), 253-265.

Graham, J., & Haidt, J. (2010). Beyond beliefs: Religions bind individuals into moral communities. Personality and Social Psychology Review, 14(1), 140-150.

Ji, C. C., Ibrahim, Y., & Kim, S. (2009). Islamic personal religion and moral reasoning in social justice and equality: The evidence from Indonesian college students. International Journal For The Psychology Of Religion, 19(4), 259-274.

Haidt, J., & Joseph, C. (2004). Intuitive ethics: How innately prepared intuitions generate culturally variable virtues. Daedalus, 133(4), 55-66. Hills, P., Francis, L.J., Argyke, M. & Jackson, C.L. (2004). Primary personality trait correlations of religious practice and orientation. Personality and Individual Differences, 36, 61-73. Hills, P., Francis, L.J., & Robbins, M. (2004). The development of the Revised Religious Life Inventory (RLI-R) by exploratory and confirmatory factor analysis. Welsh Centre for Religious Education. Jaffee, S. & Hyde, J.S. (2000). Gender differences in moral orientation: A meta-analysis. Psychological Bulletin,

126, 703-726.

Kohlberg, L. (1967). Moral and religious education and the public schools: A developmental view. In T. Sizer, (Ed.). Religion and Public Education. Boston: Houghton Mifflin. Kohlberg, L. (1969). Stage and sequence: The cognitive-development approach to socialization. In D.A. Goslin (Ed.) Handbook of Socialization Theory, 347-480. Chicago: Rand McNally. Kohlberg, L. (1976). Moral stages and moralization: The cognitive-developmental approach. In T. Lickona (Ed.), Moral development and behavior: Theory, Research, and Social Issues, 31-53. New York: Holt, Rinehart and Winston.

104 Student Psychology Journal, Volume IV STAPLETON Kohlberg, L. (1981). The philosophy of moral development: Moral stages and the idea of justice. San Francisco: Harper & Row. Lewis, C.A., Shevlin, M., McGuckin, C, & Navratil, M. (2001). The Santa Clara Strength of Religious Faith Questionnaire: Confirmatory factor analysis. Pastoral Psychology, 49, 379-384. Mayhew, M.J., Seifert, T.A., & Pascarella, E.T. (2010). A multi-institutional assessment of moral reasoning development among first-year students. Review of Higher Education, 33(3), 357-390.

dance.â&#x20AC;? American Sociological Review 63, 137-45. Rest, J.R. (1979). Development in Judging Moral Issues. University of Minnesota Press. Rest, J.R. (1980). Moral judgment research and the cognitive-development approach to moral education. The Personnel and Guidance Journal, 58 (9), 602-605. Rest, J.R. (1986). Moral development: Advances in research and theory. New York: Praeger. University of Minnesota.

Moon, Y. (1986). A review of cross-cultural studies on moral judgment development using the Defining Issues Test. Behavior Science Research, 20(1-4), 147-177. Nisan, M. & Kohlberg, L. (1982). Universality and variation in moral judgment: A longitudinal and cross-sectional study in Turkey. Child Development, 53, 865-876.

Rest, J.R. & Narvaez, D. (Eds.) (1994). Moral development in the professions: Psychology and applied ethics. Hillsdale, NJ: Lawrence Erlbaum.

Plante, T.G., & Boccaccini, M. (1997). The Santa Clara Strength of Religious Faith Questionnaire. Pastoral Psychology, 45, 375-387.

Rest, J.R., Thoma, S.J., Navaez, D. & Bebeau, M.J. (2000). A neo-Kohlbergian approach to morality research. Journal of Moral Education, 29, 381-396.

Plante, T.G., Vallaeys, C., Sherman, A.C., & Wallston, K.A. (2002). The development of a brief version of the Santa Clara Strength of Religious Faith Questionnaire. Pastoral Psychology, 50, 359-368.

Reynolds, S.J., & Ceranic, T.L. (2007). The effects of moral judgment and moral idenity on moral behavior: An empirical examination of the moral individual. Journal of Applied Psychology, 92, 1610 â&#x20AC;&#x201C; 1624.

Presser, S., & Stinson, L. (1998). Data collection mode and social desirability bias in self-reported religious atten-

Rest, J.R., Thoma, S.J., Navaez, D. & Bebeau, M.J. (1997). Alchemy and beyond: Indexing the Defining Issues Test. Journal of Educational Psychology, 89, 498-507.

Empirical Investigations MORAL REASONING AND RELIGIOSITY Sapp, G. L., & Gladding, S. T. (1989). Correlates of religious orientation, religiosity, and moral judgment. Counselling and Values, 33, 140-145. Sapp, G. L., & Jones, L. (1986). Religious orientation and moral judgment. Journal for the Scientific Study of Religion, 25, 208-214. Shee, S., Ji, C. C, & Boyatt, E. (2002). Religiosity in Christian educational leadership. Journal of Research on Christian Education, 11, 59-86. Snarey, J.R., Reimer, J., & Kohlberg. L. (1985). Development of social-moral reasoning among Kibbutz adolescents: A longitudinal cross-cultural study. Developmental Psychology, 21, 3-17. Vainio, A. (2011). Religious conviction, morality and social convention among Finnish adolescents. Journal Of Moral Education, 40(1), 73-87. Wahrman, I.S. (1981). The relationship of dogmatism, religious affiliation, and moral judgment development. The Journal of Psychology, 108, 151â&#x20AC;&#x201C;154.

105

Review Articles

Student Psychology Journal, 2013, 108- 118

The Impact of Psychological Interventions on Mood and Coping Following Moderate to Severe Acquired Brain Injury in Adults Maria Leonora Fatimah Agan Health Research Board Summer Student Scholarship 2012 National University of Ireland, Maynooth Correspondence: maria.agan2011@nuim.ie

abstract

Acquired brain injury (ABI) can result in mood disturbances that significantly impact on psychological adjustment following ABI. Anxiety and depression are commonly reported and are associated with negative outcomes. Coping styles are also associated with emotional adjustment. Literature has shown that maladaptive or dysfunctional coping, specifically avoidant coping is prevalent among people with ABI. This short review examines the relationship between psychosocial outcomes and coping strategies following ABI in adults. The impact of psychological intervention at post-acute rehabilitation stage on mood and coping is also examined. Specifically, this review focuses on follow-up studies that compare psychosocial outcomes in people with ABI who have received psychological intervention and people with ABI who did not receive such intervention, with a view to identifying effective intervention that attenuates the mood difficulties following ABI. A brief discussion on psychosocial outcomes in the absence of psychological intervention is also included in this review. Introduction Acquired brain injury (ABI) can be broadly defined as a condition arising from traumatic brain injury (TBI) and its direct consequences, cerebrovascular ac-

cident (CVA; stroke), or other acute incidents such as hypoxia (e.g., due to drowning, electrocution, anaesthetic accident), hypoglycaemia, viral encephalitis, injury arising from neurological operations, radiotherapy, cerebral abscess, bacterial

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IMPACT OF INTERVENTIONS ON MOOD AFTER BRAIN INJURY meningitis and gunshot wounds (Turner-Stokes, Nair, Sedki, Disler, & Wade, 2011). The exact incidence of ABI is difficult to ascertain due to the lack of a comprehensive database although some prevalence data exist. It is reported that the annual worldwide incidence of TBI alone is approximately 10 million (Ownsworth et al., 2011). Mood and coping impact significantly on the quality of life of individuals with ABI. For instance, greater mood disturbances such as depression and anxiety are associated with greater difficulty for individuals who have experienced TBI to return to work (Franulic, Carbonell, Pinto, & Sepulveda, 2004; McCrimmon & Oddy, 2006). The resulting financial difficulties are clinically identified as a major source of anxiety and depression (Klonoff et al., 2006). Employment has also been linked to quality of life (Steadman-Pare, Colantonio, Ratcliff, Chase, & Vernich, 2001), specifically to life satisfaction (Corrigan, Bogner, Mysiw, Clinchot, & Fugate, 2001). Moreover, individuals with TBI who are depressed or anxious report more suicidal ideation and lower psychosocial functioning (Tsaousides, Cantor, & Gordon, 2011). Follow-up studies have compared psychosocial outcomes of adults with ABI who received post-acute psychological rehabilitation and those who did not. This review aims to examine these studies in

order to identify the benefits of psychological intervention on mood issues following ABI. Studies that examined the relationship between psychosocial outcomes, specifically mood, and coping strategies are also included. Mood and coping Mood difficulties can develop as late as five years after ABI (Lincoln et al., 2013) and can persist up to 30 years after injury (Koponen et al., 2002). Post-injury depression and anxiety are commonly reported, and are associated with poor psychosocial outcomes (Bombardier et al., 2010; Draper, Ponsford, & Schรถnberger, 2007; Fleminger, Oliver, Williams, & Evans, 2003; Hoofien, Gilboa, Vakil, & Donovick, 2001; Ownsworth & Fleming, 2005; Ownsworth et al., 2011). For example, emotional problems such as frequent mood changes predict low community integration (Winkler, Unsworth, & Sloan, 2006). In contrast, Koskinen (1998) found that both individuals with TBI and their significant others report a high quality of life despite on-going emotional problems. Coping style is associated with emotional adjustment after brain injury. Anson and Ponsford (2006a) found that maladaptive coping styles such as avoidance, worry, wishful thinking, self-blame and use of drugs and alcohol are associated with poor psychosocial outcomes (e.g., higher levels of anxiety and depression) and lower

110 Student Psychology Journal, Volume IV AGAN self-esteem. Lower premorbid intelligence and greater self-awareness are associated with maladaptive coping style (i.e. non-productive, avoidant coping). This association between self-awareness and maladaptive coping style could possibly be mediated by perception of locus of control (Anson & Ponsford, 2006a). On the other hand, adaptive coping style is not associated with premorbid intelligence and self-awareness. In contrast, Ownsworth and Fleming (2005) found no association between awareness and emotional adjustment at over 2 years post-injury. However, higher premorbid intelligence is associated with lower levels of anxiety and depression (Anson & Ponsford, 2006a). Furthermore, adaptive coping styles (such as actively working on the problem, use of humour and engagement in enjoyable activities) are associated with higher self-esteem. This is consistent with Kendall and Terryâ&#x20AC;&#x2122;s (1996) predictive model which includes self-esteem as one of the personal resources that predict psychosocial adjustment through appraisal and coping. Maladaptive coping strategies predict depression and anxiety in individuals with TBI one to five years post-injury (Curran, Ponsford, & Crowe, 2000). However, Curran and colleagues (2000) found that adaptive coping (such as problem-focused coping) was weakly associated with less anxiety. There was no association found between problem-focused coping and depression. On the other hand, a coping strat-

egy involving the use of self-control and positive reappraisal is associated with lower mood disturbance and lower levels of depression (Moore & Stambrook, 1992). Contrary to these findings, Spatt, Zebenholzer, and Oder (1997) found that preserved self-control is associated with depression. These two studies used different measures of depression and self-control, and are therefore not comparable. The use of different measures could also possibly account in part for the different outcomes. Rutterford and Wood (2006) found that coping and appraisal alone cannot predict the outcomes but a combination of these two factors and other variables such as personality and self-efficacy is able to predict psychosocial outcomes in the domains of community integration, life satisfaction and quality of life. Individuals with ABI who show depressive symptoms focus on negative emotions and display more avoidant coping such as mental disengagement (Finset & Andersson, 2000). It is also less common for individuals with ABI to use an approach-oriented coping style such as seeking social support. Furthermore, a simulated real-world stress test revealed that a high proportion of people with moderate to severe TBI engage more in avoidant coping than neurologically healthy individuals (Krpan, Stuss, & Anderson, 2011). Tomberg, Toomela, Pulver and Tikkâ&#x20AC;&#x2122;s (2005) study also revealed that the use of task-oriented strategy in conjunct-

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IMPACT OF INTERVENTIONS ON MOOD AFTER BRAIN INJURY ion with social and emotional support is diminished in individuals with TBI while the use of avoidance strategies is greater compared to neurologically healthy individuals. In this study, the support network of individuals with TBI tended to be smaller, and it is suggested that this is possibly due to changes in mood, behaviour and inter-personal relationships as well as reduced social activity. However, the quality rather than the extent of support (i.e. size of network) is more important to the individualâ&#x20AC;&#x2122;s satisfaction with support. Satisfaction with support is associated with health-related quality of life (Tomberg et al., 2005). A follow-up study two years later revealed an increase in seeking social or emotional support. However, the use of an avoidant coping style remained more prevalent than the task-oriented style. In this context, the increase in seeking emotional support is maladaptive because of the focus on reducing stress-related emotional reactions without addressing the causes of stress (Tomberg, Toomela, Ennok, & Tikk, 2007). At follow-up, those with fewer emotional and physical problems showed an increase in the use of task-oriented strategies while those who had a limited support network showed an increase in the use of avoidant coping styles. Effects of Intervention on Outcomes Psychological interventions after ABI seem to be beneficial. It has been shown that a multi-disciplinary approach to reha-

bilitation hastens improvement in problem areas including emotional difficulties (see Turner-Stokes et al., 2011 for review). Svendsen and Teasdale (2006) compared a group of rehabilitated and non-rehabilitated adults with ABI 12 to 22 years post-injury. The post-acute rehabilitation programme was an interdisciplinary, holistic approach tailored to the individualâ&#x20AC;&#x2122;s needs based on neuropsychological assessments. The ABI adults in the rehabilitated group (n = 37) and their significant others both reported lower levels of brain injury symptoms and a higher degree of personal competency compared to the non-rehabilitated adults (n = 13) and their significant others. The rehabilitated group also reported a higher degree of internal locus of control and self-efficacy. Lower levels of anxiety and depression were also found in this group. However, ABI adults had a higher level of anxiety and depression compared to their non-brain injured significant others. Notwithstanding, this study provided evidence that post-acute rehabilitation can alleviate the levels of depression. The rehabilitated group also reported a better quality of life with a medium effect size of rehabilitation. Interestingly, the ABI adults enrolled in the rehabilitation programme were those who were unable to return to work after the injury. Previous studies have indicated that the inability to return to work impacts on the quality of life of the ABI adults (Corrigan et al., 2001; Klonoff et al., 2006). This suggests that post-acute rehabilitation can moderate the impact of)

112

Student Psychology Journal, Volume IV AGAN

unemployment on psychosocial outcome following ABI. Cognitive behaviour therapy (CBT also has a potential to improve the under standing and management of emotional issues experienced by individuals with ABI, and improve their ability to use adaptive coping strategies (Doering & Exner, 2011; Fleminger et al., 2003). This is the case if the treatment specifically targets emotional issues and coping skills (see Waldron, Casserly, & Oâ&#x20AC;&#x2122;Sullivan, 2013 for review). Anson and Ponsford (2006b) found that participants in a CBT-based intervention programme significantly improved in their use of adaptive coping skills. However, these gains were not stable and declined at five weeks post-intervention follow-up but increased again at a later follow-up. This pattern is possibly due to cognitive difficulties and behavioural rigidity that led to a failure in implementing the strategies previously learned. However, these fail to account for the later increase in adaptive coping (Anson & Ponsford, 2006b). Levels of anxiety, depression, self-esteem and psychosocial functioning did not significantly change over time. It was suggested that this lack of improvement could be due to an increase in self-awareness brought about by the intervention. However, self-awareness was not measured at follow-up. Thus it was not possible to verify an increase in self-awareness among the participants. Increased self-awareness has been shown to be associated with anx-

iety and depression (Wallace & Bogner, 2000) and emotional dysfunction in general (Godfrey, Partridge, Knight, & Bishara, 1993). Another possible explanation is that the outcomes do not generalise to domains that were not specifically targeted (Waldron et al., 2013). Nonetheless, this study has shown that adaptive coping strategies can be learned through a CBT-based intervention, given that it is the aim of the programme. Ownsworth, McFarland and Young (2000) found improved psychosocial outcomes in people with ABI who were, on average, 8.6 years post-injury and had attended a 16-week group support programme. This programme aimed at improving self-awareness deficits and psychosocial functioning, specifically on the areas of social interaction, cognitive abilities, emotional well-being and communication skills. The approach was a combination of CBT, cognitive rehabilitation and social skills. Specifically, participants were taught techniques in problem-solving and relaxation, and participated in guided self-reflection, role plays and developing compensatory strategies, as well as practicing new behaviours within the workshop. Results of the study showed improved levels of self-regulation skills and psychosocial functioning. A 6-month follow-up showed that these gains were maintained within that period. Ownsworth and colleagues (2000) suggested that the programme facilitated learning of coping

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IMPACT OF INTERVENTIONS ON MOOD AFTER BRAIN INJURY strategies which enhanced these self-regulation skills, enabling them to manage emotional and behavioural difficulties. A mindfulness-based intervention was also found to significantly improve levels of depression in a small group of TBI patients (n = 10). BĂŠdard and colleagues (2003) found an improvement of depressive symptoms and quality of life among those who received the intervention. However, such an intervention is only beneficial to those who do not have impaired self-awareness since the intervention involves insight meditation. This limits the utility of a mindfulness-based intervention since a lack of insight or self-awareness is common after brain injury (see Bach & David, 2006 for review).

physical and psychological skills (Driver & Ede, 2009). However, the stability of positive change in mood could not be established from this study due to the lack of follow-up.

Physical activity has also been shown to improve mood problems after brain injury. Driver and Ede (2009) compared a group (n = 8) who had undergone an 8-week aquatic programme and a control group (n = 8) who had undergone an 8-week vocational rehabilitation class. There was a significant improvement on levels of tension, depression, anger, vigour, fatigue and confusion among those who engaged in physical activity and the effect size was large. There were no significant changes in any area among those who engaged in vocational rehabilitation. It was suggested that participation in physical activity as part of rehabilitation promotes self-efficacy through mastery of

Outcomes Following No Intervention

Participation in a self-help group was also found to improve mood in people with ABI. Man, Yip, Ko, Kwok and Tsang (2010) suggested that social connections and social support from members of the self-help group make a significant improvement to mood difficulties. This study showed that those who were at a longer time post-injury (i.e. over five years) showed a greater intensity of positive affects and focused more on looking for positivity rather than changing the negative mood.

Positive outcomes can be observed over time even without post-acute rehabilitation intervention. Individuals with TBI at 10 to 12 years after injury reported more positive outcomes in terms of relating to others, personal strength, new possibilities and greater appreciation of life and spirituality compared to individuals with TBI at one to three years after injury (Powell, Ekin-Wood, & Collin, 2007). Social support and personal skills (e.g., determination, belief in self) were the two most important factors associated with these outcomes, consistent with findings that strong social support is associated with

114 Student Psychology Journal, Volume IV AGAN high positive affect (Man et al., 2004). Specifically, emotional support had the strongest association with quality of life 8 to 24 years after TBI (Steadman-Pare et al., 2001). A population-based survey also found better mood and quality of life at, on average, 29 years after injury (Brown et al., 2011). Furthermore, injury severity had no significant impact on mood or quality of life. Similarly, a population-based study of individuals with stroke and TBI also revealed a better quality of family relationships and other social relationships at 15 years post-injury compared to earlier follow-up (Teasdale & Engberg, 2005a,b). It was suggested that this finding could be partly due to a higher long-term survival rate among those who have family and social support, implying that social support impacts on the long-term survival of stroke patients. However, the population-based studies discussed above did not examine possible engagement in interventions as a factor. Conclusion Follow-up studies have consistently found an association between mood problems and poor outcomes, as well as the prevalent use of avoidant coping among the brain injured population. However, as these studies are correlational, it is impossible to conclude whether mood problems can be attributed to poor outcomes or poor

outcomes can be attributed to mood problems. The use of different cohorts with varying numbers of years post-injury and the use of different measures and different dimensions of psychosocial outcomes make it impossible to compare these studies. Moreover, these outcomes can be subjective and are operationally defined in different ways in different studies. For example, in terms of quality of life, there is no universal definition of what this term means (Seibert et al., 2002). Although differences in sampling and methodology exist, the consistency in their findings clearly indicates that mood and coping can impact on psychosocial outcomes postABI. An assessment of mood and coping is warranted at the post-acute rehabilitation stage. While some evidence exists that positive outcomes are possible even without psychological intervention, it is generally shown that post-acute rehabilitation is beneficial to people with ABI. This review discussed intervention studies that included a multi-disciplinary approach, CBTbased programme, a group support programme using a combination of various approaches, a mindfulness-based intervention, physical activity, and participation in a self-help group. The studies discussed here seem to suggest that a combination of various approaches has more therapeutic value than a single approach (e.g., CBT alone) since it addresses several domains while a single approach may target speci-

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IMPACT OF INTERVENTIONS ON MOOD AFTER BRAIN INJURY fic domains with results that do not generalise to other difficulties that need to be addressed. However, given the relatively small sample sizes in the studies discussed above, it is difficult to make conclusions based on these studies. Furthermore, the data on the stability of outcomes are limited. Thus, there is an issue of whether the efficacy of the intervention is temporary or permanent. This raises further questions on the duration of intervention programmes and how often the individual must attend in order to gain and maintain the desired outcomes. These highlight the need for longitudinal studies. It is also important to note that these studies show performance as a group. This implies that not everyone achieved the same outcomes and that the specific intervention may suit some more than others. Rehabilitation may be most beneficial if it is tailored according to the participantsâ&#x20AC;&#x2122; needs. The challenge therefore is to determine which issues need to be addressed in order to design an intervention that suits a particular individual. References Anson, K., & Ponsford, J. (2006a). Coping and emotional adjustment following traumatic brain injury. Journal of Head Trauma Rehabilitation, 21(3), 248-259. Anson, K. & Ponsford, J. (2006b). Evaluation of a coping skills group following traumatic brain injury. Brain Injury, 20(2), 167-178.

Bach, L.J., & David, A.S. (2006). Self-awareness after acquired and traumatic brain injury. Neuropsychological Rehabilitation, 16(4), 397414. BĂŠdard, M., Felteau, M., Mazmanian, D., Fedyk, K., Klein, R., Richardson, J., Minthorn-Biggs, M. (2003). Pilot evaluation of a mindfulness-based intervention to improve quality of life among individuals who sustained traumatic brain injuries. Disability and Rehabilitation, 25(13), 722-731. Bombardier, C.H., Fann, J.R., Temkin, N.R., Esselman, P.C., Barber, J., & Dikmen, S.S. (2010). Rates of major depressive disorder and clinical outcomes following traumatic brain injury. Journal of American Medical Association, 303(19), 1938-1945. Brown, A.W., Moessner, A.M., Mandrekar, J., Diehl, N.N., Leibson, C.L., & Malec, J.F. (2011). A survey of very-long-term outcomes after traumatic brain injury among members of a population-based incident cohort. Journal of Neurotrauma, 28, 167-176. Corrigan, J.D., Bogner, J.A., Mysiw, W.J., Clinchot, D., & Fugate, L. (2001). Life satisfaction after traumatic brain injury. Journal of Head Trauma Rehabilitation, 16(6), 543-555. Curran, C.A., Ponsford, J.L., & Crowe, S. (2000). Coping strategies and emotional outcome following traumatic brain injury: A comparison with orthopedic patients. Journal of Head Trauma Rehabilitation, 15(6), 12561274.

116 Student Psychology Journal, Volume IV AGAN Doering, B., & Exner, C. (2011). Combining neuropsychological and cognitive - behavioural approaches for treating psychological sequelae of acquired brain injury. Current Opinion in Psychiatry, 24, 156-161. Draper, K., Ponsford, J., & SchĂśnberger, M. (2007). Psychosocial and functional outcomes 10 years following traumatic brain injury. Journal of Head Trauma Rehabilitation, 22(5), 278-287. Driver, S., & Ede, A. (2009). Impact of physical activity on mood after TBI. Brain Injury, 23(3), 203-212. Finset, A., & Andersson, S.( 2000). Coping strategies in patients with acquired brain injury: Relationships between coping, apathy, depression and lesion location. Brain Injury,14(10), 887905. Fleminger, S., Oliver, D.L., Williams, W.H., & Evans, J. (2003). The neuropsychiatry of depression after brain injury. Neuropsychological Rehabilitation, 13(1/2), 65-87. Franulic, A., Carbonell, C.G., Pinto, P., & Sepulveda, I. (2004). Psychosocial adjustment and employment outcome 2, 5 and 10 years after TBI. Brain Injury, 18(2), 119-129. Godfrey, H.P.D., Partridge, F.M., Knight, R.G., & Bishara, S. (1993). Course of insight disorder and emotional dysfunction following closed head injury: A controlled cross-sectional follow-up study. Journal of Clinical and Experimental Neuropsychology,

15 (4), 503-515. Hoofien, D., Gilboa, A., Vakil, E., & Donovick, P.J. (2001). Traumatic brain injury (TBI) 10-20 years later: A comprehensive outcome study of psychiatric symptomatology, cognitive abilities and psychosocial functioning. Brain Injury, 15(3), 189-209. Kendall, E., & Terry, D.J. (1996). Psychosocial adjustment following closed head injury: A model for understanding individual differences and predicting outcome. Neuropsychological Rehabilitation, 6(2), 101-132. Klonoff, P.S., Watt, L.M., Dawson, L.K., Henderson, S.W., Gehrels, J., & Wethe, J.V. (2006). Psychosocial outcomes 1-7 years after comprehensive milieu-oriented neurorehabilitation: The role of pre-injury status. Brain Injury, 20(6), 601-612. Koponen, S, Taiminen, T., Portin, R., Himanen, L., Isoniemi, H., Heinonen, H., â&#x20AC;Ś Tenovuo, O. (2002). Axis I and II psychiatric disorders after traumatic brain injury: A 30-year follow-up study. The American Journal of Psychiatry, 159( 8), 1351-1321. Koskinen, S. (1998). Quality of life 10 years after a very severe traumatic brain injury (TBI): The perspective of the injured and the closest relative. Brain Injury, 12(8), 631-648.

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IMPACT OF INTERVENTIONS ON MOOD AFTER BRAIN INJURY Krpan, K.M., Stuss, D.T., & Anderson, N.D. (2011). Planful versus avoidant coping: Behavior of individuals with moderate-to-severe traumatic brain injury during a psychosocial stress test. Journal of the International Neuropsychological Society, 17, 248-255. Lincoln, N.B., Brinkmann, N., Cunningham, S., Dejaeger, E., De Weerdt, W., Jenni, W., De Wit, L. (2013). Anxiety and depression after stroke: A 5 year follow-up. Disability and Rehabilitation, 35(2), 140-145. Man, D.W.K., Lee, E.W.T., Tong, E.C.H., Yip, S.C.S., Lui, W.F., & Lam, C.S. (2004). Health services needs and quality of life assessment of individuals with brain injuries: A pilot cross sectional studies. Brain Injury, 18(6), 577-591. Man, D.W.K., Yip, P.F.W., Ko, T.H.L., Kwok, J.K.L., & Tsang, M.Y. (2010). Quality of life of individuals with acquired brain injuries. Applied Research Quality Life, 5, 27-34. McCrimmon, S., & Oddy, M. (2006). Return to work following moderate-to-severe traumatic brain injury. Brain Injury, 20(10), 1037-1046. Moore, A.D., & Stambrook, M. (1992). Coping strategies and locus of control following traumatic brain injury: Relationship to long-term outcome. Brain Injury, 6(1), 89-94. Ownsworth, T., & Fleming, J. (2005). The relative importance of metacognitive skills, emotional status, and executive function in psychosocial adjustment following acquired brain injury. Jour-

nal of Head Trauma Rehabilitation, 20(4), 315-332. Ownsworth, T., Fleming, J., Haines, T., Cornwell, P., Kendall, M., Nalder, E., & Gordon, C. (2011). Development of depressive symptoms during early community reintegration after traumatic brain injury. Journal of the International Neuropsychological Society, 17, 112-119. Ownsworth, T.L., McFarland, K., & Young, R.M. (2000). Self-awareness and psychosocial functioning following acquired brain injury: An evaluation of a group support programme. Neuropsychological Rehabilitation, 10(5), 465-484. Powell, T., Ekin-Wood, A., & Collin, C. (2007). Post-traumatic growth after head injury: A long-term follow-up. Brain Injury, 21(1), 31-38. Rutterford, N.A., & Wood, R.L. (2006). Evaluating a theory of stress and adjustment when predicting long-term psychosocial outcome after brain injury. Journal of the International Neuropsychological Society, 12, 359-367. Seibert, P.S., Reedy, D.P., Hash, J., Webb, A., Stridh-Igo, P., Basom, J., & Zimmerman, C.G. (2002). Brain injury: Quality of lifeâ&#x20AC;&#x2122;s greatest challenge. Brain Injury, 16(10), 837-848. Spatt, J., Zebenholzer, K., & Oder, W. (1997). Psychosocial long-term outcome of severe head injury as perceived by patients, relatives, and professionals. Acta Neurologica Scandinavica, 95,173-179.

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Steadman-Pare, D., Colantonio, A., Ratcliff, G., Chase, S., & Vernich, L. (2001). Factors associated with perceived quality of life many years after traumatic brain injury. Journal of Head Trauma Rehabilitation, 16(4), 330-342. Svendsen, H.A., Teasdale, T.W. (2006). The influence of neuropsychological rehabilitation on symptomatology and quality of life following brain injury: A controlled long-term follow-up. Brain Injury, 20(12): 1295-1306. Teasdale, T.W., & Engberg, A.W. (2005a). Subjective well-being and quality of life following traumatic brain injury in adults: A long-term population-based follow-up. Brain Injury, 19(12), 1041 1048. Teasdale, T.W., & Engberg, A.W. (2005b). Psychosocial consequences of stroke: A long-term population-based follow-up. Brain Injury, 19(12), 10491058. Tomberg, T., Toomela, A., Ennok, M., & Tikk, A. (2007). Changes in coping strategies, social support, optimism and health-related quality of life following traumatic brain injury: A longitudinal study. Brain Injury, 21(5): 479-488. Tomberg, T., Toomela, A., Pulver, A., & Tikk, A. (2005). Coping strategies, social support, life orientation and health-related quality of life following traumatic brain injury. Brain Injury, 19(14), 1181-1190. Tsaousides, T., Cantor, J.B., & Gordon,

W.A. (2011). Suicidal ideation following traumatic braininjury: Prevalence rates and correlates in adults living in the community. Journal of Head Trauma Rehabilitation, 26(4), 265275.

Turner-Stokes, L., Nair, A., Sedki, I., Disler, P.B., & Wade, D.T. (2011). Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database of Systematic Reviews 2005 (3), 1-46. doi: 10.1002/14651858.CD004170. pub2. Waldron, B., Casserly, L. M., & Oâ&#x20AC;&#x2122;Sullivan, C. (2013). Cognitive behavioural therapy for depression and anxiety in adults with acquired brain injury. What works for whom?, Neuropsychological Rehabilitation: An International Journal, 23(1), 64-101. Wallace, C.A., & Bogner, J. (2000). Awareness of deficits: emotional implications for persons with brain injury and their significant others. Brain Injury, 14 (6), 549-562. Winkler, D., Unsworth, C., & Sloan, S. (2006). Factors that lead to successful community integration following severe traumatic brain injury. Journal of Head Trauma Rehabilitation, 21(1), 8-21.

Student Psychology Journal, 2013, 119-131

Irish Organised Crime and the Motivation Behind Gangland Killings. Sadhbh Byrne Trinity College, Dublin Correspondence: byrnes30@tcd.ie

abstract

Organised crime is a worldwide phenomenon, and yet proves difficult to define. In Ireland, organised crime is centred, for the most part, on gangland activity and related killings. Public perceptions of gangland homicide support a strong link to the drug trade, however the current review discusses the importance of recognising several motivating factors, including the inherent nature of gang mentality, social and economic factors, family factors, psychological and biological factors, and the possibility of psychopathology. Although there is no one theory that can account for gangland killings, social cognitive theory can be used to partially explain this behaviour. However, disentangling these violent crimes from the gangland background is extremely problematic. This is compounded by the paucity of empirical research on Irish gangland activity. Consequently, there is ambiguity surrounding the relative importance of each of these factors, and further research, of a multidisciplinary nature, is thus recommended. “For me it was just business. I didn’t know the guy. I’d never seen him before. He had to go. That’s all I knew. That’s all I needed to know.” -Athony ‘Gaspipe’ Casso Introduction This paper considers organised crime in Ireland, most pertinently the associated homicides that are committed in Irish gangland activity. The paper provides a short synthesis of the available knowledge that can inform our understanding

of the motivation behind these gangland murders, by considering the impact of several elements, including the inherent nature of gangs, the link with drugs, social and economic factors, family upbringing, psychological and biological factors, and psychopathology. In its examination of these factors, this paper

120 Student Psychology Journal, Volume IV BYRNE argues that the complex nature of the motivation behind gangland homicide necessitates the development of a similarly complex theoretical model to explain this phenomenon, incorporating the aforementioned elements. Social cognitive theory can be utilised to explain this in part, however certain motivating aspects are neglected. Thus, this paper further argues that research in this area must be multidisciplinary in nature, and cross the traditional boundaries of knowledge disciplines. Levi (1998) stated “the term ‘organised crime’ is frequently used but difficult to define”, and indeed defining ‘organised crime’ is a challenging task; Thomas Schelling, in his book Choice and Consequence (1984) makes an appropriate point when he discusses how it does not merely refer to ‘crime that is organised’. A more recent attempt to define organised crime was put forward by the European Commission and Europol (2001; as cited in Wright, 2006), where a list of eleven factors associated with organised crime was delineated. In order for organised crime to be considered present, four of these factors were deemed essential: “collaboration of more than two people, for a prolonged or indefinite period of time, suspected of the commission of serious criminal offences, determined by the pursuit of profit and/or power”. Organised crime in Ireland is centred, for the most part, around gangland activity (Davey, 2008; Campbell, 2008). Decker and Van Winkle (1996) define a

gang as “an age-graded peer group that exhibits some permanence, engages in criminal activity, and has some symbolic representation of membership”. However, unlike, for example, gangs in North and South America, Irish gangs are not typically based around ethnicity. This makes an understanding of the motivation behind Irish gangland homicide more difficult, as international research cannot be assumed generalisable. Public Perceptions In the late 1990s to early 2000s in Ireland, general public consciousness was hyper-aware of gangland activity, in particular murder perpetrated by gang members. Organised crime and its related gangland killings was a very recent introduction to Ireland (Campbell, 2008), and a sense of crisis permeated the fabric of society, spurred on by the escalating nature of the problem. In a two-year period (1994-1996), a 424% increase in the amount of Irish Times articles mentioning ‘organised crime’ was noted (Meade, 2000). This anxiety was reflected not only in media reports, but also by official reports released by political parties; Fine Gael deemed the country “ungovernable” due to “rampant gangland crime” (Fine Gael National Press Office, 2006; as cited in Campbell, 2010), and the Labour Party compared Ireland to Bogota (Labour Press Office, 2005; as cited in Campbell, 2008).

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ORGANISED CRIME AND GANAGLAND KILLINGS Despite almost two decades of considerable attention from politics, public, and and press, a manifestation of which can be seen in the popularity of RTÉ drama Love/Hate, there is no corresponding abundance of academic or empirical research (O’Donnell, 2005; Davey, 2008). The low conviction rates associated with gangland killings are a major reason for this (Campbell, 2008; O’Mahony, 2008). This dearth of empirical investigations leaves room for speculation and assumption, which thus leads to difficulties in truly understanding the phenomenon, or conducting a reasoned study of motivational factors behind gangland murder. There are various potential motives behind gangland homicide, and this paper aims to address some of the many possible drives behind this phenomenon. The Nature of Gangs Violence is an inherent and vital aspect of gang life (Klein & Maxson, 1989; Wright, 2006). There are also factors related to the nature of gangs themselves which are pertinent in terms of motivation; for example, it is likely that the severity of punishment for treachery imparted by fellow members is perceived as much greater than that afforded by the legal system (McCarthy, Hagan, & Cohen, 1998; Reuter, 1983). Conditions of gang membership may include such assumptions as non-compliance with An Garda Síochána (von Lampe & Johansen, 2004). Thus if

one is ordered to carry out a murder on behalf of the gang, there may not appear to be a choice in whether this order is executed. The media attention afforded to Irish gangs has been previously addressed. This attention may result in a certain type of glamour becoming attached to gang membership, and the associated violent crime. It is possible that there may be a motivation to commit violent crimes or homicide in order to gain access to the inner echelons of fame and power within the gang. In Joe Pistone’s famed book, Donnie Brasco: My undercover life in the Mafia, the attitude of Benjamin ‘Lefty’ Ruggiero is outlined: “As a wiseguy you can lie, you can cheat, you can steal, you can kill people – legitimately. You can do any goddamn thing you want, and nobody can say anything about it. Who wouldn’t want to be a wiseguy?” (Pistone & Woodley, 1988). Studies have suggested that, even in young children, the prospect of attaining peer approval or status is a motivating factor behind aggression (Miller, 1958; Buehler, Patterson, & Furniss, 1966; Short, 1968). However, it is clear that this factor is not the sole motivation behind the committing of gangland killings, with factors such as drugs more commonly highlighted as an important influence in the media. The Drugs and Violent Crime Link

Widespread public belief in Ireland

122 Student Psychology Journal, Volume IV BYRNE assumes that there is a strong association between gangland homicide and drugs (Connolly, 2006). Paul O’Mahony (2000, p. 23) posits that increasing rates of drug addiction in Ireland has “translated into a growth in the violence of crime and in the breaking of previously well-established taboos against victimising the vulnerable”. O’Donnell (2005) stated the organisation of the drug trade is a contributing factor in most gangland killings. In the official Irish governmental definition of organised crime, as proposed by the Department of Justice and Equality, a list of activities associated with organised crime is given; it is interesting that murder or manslaughter is not present in this list, however drug trafficking is deemed to be one of three most damaging associated factors (Department of Justice and Equality, 2012). However, in perhaps the most comprehensive empirical examination of the Irish drugs-crime link thus far, a report for the Health Research Board (HRB) by Johnny Connolly (2006), it was concluded that rates of violent crime perpetrated by drug users are not in line with the strong relationship assumed by the Irish public. White and Gorman (2000), in a similar American study, warn that the links between drug use and crime are prone to exaggeration. There are four main models of the link between drugs and crime; the model which perhaps best addresses this link in terms of gangland violence is the systemic model, which claims that interaction with

and within the drugs market itself, and associated factors, results in crime (White & Gorman, 2000). Connolly names the following types of crime as being associated with systemic aspects of the Irish drug trade: “gangland murders and fights over organisational and territorial issues, disputes over transactions or debt collection, and corruption of business and government officials” (Connolly, 2006, p. 26). Drugs themselves may also have influence on crime, in that it has been suggested that perpetrators may ingest certain drugs, particularly stimulants such as cocaine, prior to the execution of homicide (O’Mahony, 2008; Connolly, 2006). Alcohol, a drug that has particular relevance to Irish culture, has also been shown to have an effect in terms of the committing of violent crime (O’Mahony, 2008). In a meta-analysis conducted by Parker and Auerhahn (1998), a conclusion was made that “when violent behaviour is associated with a substance, that substance is, overwhelmingly, alcohol” (Parker & Auerhahn, 1998, p. 306). However, due to the low conviction rates of gangland killers, as mentioned previously, there is insufficient evidence with regards to the intoxication of perpetrators in these particular circumstances. This dearth of evidence reiterates the importance of consideration of all causal factors.

Social and Economic Factors

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ORGANISED CRIME AND GANAGLAND KILLINGS Gangland culture is mostly situated in Ireland’s larger cities, including Limerick and the capital Dublin. Urban living has inherent effects on the motivations behind the committing of violent crime and homicide. Antisocial behaviour has been shown to be contingent on three conditions of urban inhabitation: poverty, heterogeneity, and mobility (Blau & Blau, 1982). Similarly, results of a meta-analysis (Lipsey & Derzon, 1998; as cited in Palmer, 2008) suggested that predictors of violence included “being male, low socioeconomic status, poor relationship with parents, involvement in general delinquency and drug use from a young age, a history of aggression and violence, antisocial peers, poor attitudes towards school, and poor school performance”. Tuvblad and colleagues (2006) report extremely interesting results from their longitudinal study of Swedish twins. 2,133 twins participated in this research, which examined the heritability of antisocial behaviour. It was demonstrated that genetic effects on antisocial behaviour were higher for adolescents from areas of socioeconomic advantage; environmental influences did not have as strong an effect. The opposite was true for those with a low socioeconomic background, for whom environment was a critical factor in the development of antisocial tendencies. Thus we can see that social factors are most influential in urban, low socioeconomic areas – precisely those that are home to Ireland’s

ganglands. In the words of Ian O’Donnell (2005, p. 112), “…an unequal society creates a context for violent crime”. Some gangland killings may be economically motivated, as the crime may be committed, for example, on the promise of remission of debt (Connolly, 2006). Connolly (2006) also suggests that when legitimate employment is available, levels of drug-related crime should drop. However, this line of thought should then imply that gangland crime should increase due to economic motives in the context of unemployment in recessionary times; conversely, gangland crime spiked during the Celtic Tiger years and has dropped dramatically in the recession (Lally, 2012). It is, of course, crucial to note that not all individuals who grow up in similar social and economic circumstances become gang members or commit gang-related murder, which supports the existence of other individuating factors – one of the most prominent being family upbringing. Family Factors It is possible, and widely perceived, that many Irish gangs are composed to a large extent of various members of the same extended family. Thus, issues surrounding the family environment both in the present and during development most likely have a part to play in the motivation to commit violent crime. Similarities in

124 Student Psychology Journal, Volume IV BYRNE aggressive and antisocial tendencies have been found between members of the same family (Miles & Carey, 1997). Social cognitive theory and earlier theories of operant learning are crucial factors in the family setting. Research has shown that in a family environment where there are encouraging or tolerant attitudes toward aggression, this can act as instruction in aggression for children (Bandura & Walter, 1959; Hollenberg & Sperry, 1951). For example, Mafia crime boss Lefty Ruggiero, when presenting his grandson with a toy gun, said “Now you can be a tough guy like your granddad. You can be a shooter when you grow up, just like me” (Abadinsky, 2010). International research consistently supports that criminal behaviour can be predicted by a parental background in crime, as reported by Jamel (2008). Parental discipline of either extreme, either excessively authoritarian or permissive, or inconsistent disciplinary measures, has also been shown to have negative effects on child development, particularly with regards to aggression (Abadinsky, 2010; Miles & Carey, 1997; Palmer, 2008). Childhood abuse, or bearing witness to domestic abuse, has also been shown to have long-lasting effects on attitudes towards committing violent crime (Palmer, 2008). Aggression may thus be normalised, especially that which takes place in the presence or at the behest of family members – such as when con-

tracted to commit gangland killings. It is likely however that in order for such social learning to take place, a psychological predisposition towards violence is perhaps already present. Psychological Factors Although the evidence is clear that certain environments and family situations are associated with involvement in violent crime, as previously stated it cannot be said that every individual situated in such circumstances goes on to engage in crime (Abadinsky, 2010). Therefore, it is likely that individual psychological factors also play a role in gangland murder motivation. Several psychological factors have been proposed to motivate violent crime. Historically, psychological assessments of criminals were concerned with phrenology and its apparent ability to discern criminals from the general population due to the shape of each individual’s skull (Jamel, 2008). Phrenological theories have long since been disproved, but one of the most consistent contemporary findings regarding the psychology of crime concerns low self-control (Gottfredson & Hirschi, 1990). Other contributing factors that have been posited include a need for immediate gratification, depression and high fearfulness (Palmer, 2008), which may lend themselves to a psychological profile likely to commit murder. Personality theories have demonstrated support that criminal

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ORGANISED CRIME AND GANAGLAND KILLINGS offenders typically rate highly in terms of psychoticism and neuroticism (Eysenck & Gudjonsson, 1989). These general theories of crime serve to supplement the other motivating elements of gangland homicide in particular, supporting the hypothesis that the causal factors are complex. Biological Factors Although environmental and personality factors such as those examined above have been shown to play a role in the development of criminally violent behaviour, these factors have been shown to account for only a tiny portion of the variance involved (Tuvblad, Grann, & Lichtenstein, 2006). Biological and genetic factors are also worth consideration, especially given the fact that perpetrators of violent crime are predominantly male, giving strong evidence for possible biological underpinnings (Howitt, 2009). It has been demonstrated that the link between testosterone and aggression is related to reduced neural activity in the orbitofrontal cortex, the brain area that is associated with self-regulation (Menta & Beer, 2009). This shows a possible link with the psychological construct of low self-control as mentioned above. Early 21st century evidence from the literature suggested that the link between brain dysfunction and extreme violence is negligible (Coleman & Norris, 2000). However, in more recent studies are shed-

ding new light on this. In an extremely interesting piece of research conducted in India (Rajender, Pandu, Sharma, Ghandi, Singh, & Thangaraj, 2008), 645 male participants were examined, 241 of whom had been convicted of rape, 107 of murder, 26 of both murder and rape, and 271 of whom were in the control group. A particular type of repeat exists in the androgen receptor (AR) gene called the CAG repeat; this study demonstrated significantly shorter CAG repeats in those who had committed murder and those who had committed rape in comparison to control participants. However, more intriguingly again, the group of participants who had been convicted of both murder and rape (the most violent offenders) had shorter CAG repeats than the other three groups, thus lending support to the notion of a biological root to violent crime (Rajender et al., 2008). Possible genetic links to less extreme antisocial behaviour generally have been supported by numerous studies (Tuvblad, Grann, & Lichtenstein, 2006). In a longitudinal study of American adolescents (Vaughn, Delisi, Beaver, & Wright, 2009), strong support was shown for the effects of certain genes (DAT1 and 5HTT), which affect certain neurotransmitters (dopamine and serotonin) on criminal behaviour; however, environmental features, specifically the peer network, mediated this effect. Pertinently, this study controlled for self-control: all in all, demonstrating the complexity of Environ-

126 Student Psychology Journal, Volume IV BYRNE Environment X Personality X Biology models. This complexity must be taken into account when considering the motivating factors of gangland crime. Yet another factor worth consideration is the possibility of psychopathology. Psychopathology Describing his first murder, Sammy Gravano said, “Am I supposed to feel remorse? Aren’t I supposed to feel something? But I felt nothing like remorse. If anything, I felt good. Like high. Like powerful, maybe even superhuman. It’s not that I was happy or proud of myself. Not that. I’m still not happy about that feeling. It’s just that killing came so easy to me” (Abadinsky, 2010, p. 37). This excerpt clearly demonstrates flat affect, lack of empathy and grandiose sense of self-worth, which are all factors on Robert Hare’s Psychopathy Checklist (Hare, Clark, Grann, & Thornton, 2000). In the context of this paper’s previous discussion of both environmental (considering both society and family) and biological factors, Mealey’s (1995) model of sociopathy is especially relevant. This model postulates two pathways of sociopathic development: primary and secondary. Primary sociopathy comes about as a result of abnormal moral development; the individual expresses no social responsibility, due to the influence of their genes. A disadvantageous environment is associat-

ed with secondary sociopathy. Risk factors for secondary sociopathy include “low socioeconomic status, urban residency, low intelligence, and poor social skills” (Miles & Carey, 1997, p. 216). It is pertinent to note that these factors associated with the development of secondary sociopathy reflect those deemed relevant to violent crime perpetration. Theoretical Underpinnings Gangland killings can thus be attributed to many factors: inherent aspects of gang membership, social and economic issues, the influence of drugs and involvement with the drug trade, consequences arising from the family environment, individual psychological characteristics, genetic and other biological effects, and psychopathology. It seems that should an individual perpetrate violent crime, such as that involved in gangland homicide, a combination of some or all of these factors are likely to be at play. Given the difficulty inherent in extricating the relative importance of each of these factors, it is not surprising that there is no one model available at present to account for all motivating factors behind gangland murder. This is further compounded by the scarcity of research in this area. However any multi-factor model must take into account existing psychological theories of violence, such as, for instance, the aforementioned social cogniti-

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ORGANISED CRIME AND GANAGLAND KILLINGS ve theory (Bandura, Ross & Ross, 1961). Social cognitive theory generally posits that human behaviour is determined by learning in social environments, through imitation and modelling of behaviour. However in recent years this theory has been reviewed from an agentic perspective, which states that human behaviour is not solely based on the interpretation and incorporation of other’s behaviour, but also acts as agents of their own actions (Bandura, 2001).

rectly, but rather by influencing various factors related to the individual’s self-regulation, such as their aspirations and sense of efficacy (Bandura, 2001). Accordingly, the theory rejects the proposal that sociostructural determinants of behaviour are distal in their causative influence, but rather than they impact individual’s lives proximately; “multicausality involves codetermination of behaviour, not causal dependencies between levels” (Bandura, 2001, p.15).

In terms of the execution of violent crime, this agentic perspective on social cognitive theory states that although individuals typically restrain their behaviour to that which is morally correct, when committing violent crime individuals can disengage these self-imposed restraints by cognitively construing the victim as dehumanised, having bestial attributes, or drawing the suffering onto themselves (Bandura, 2001). Those individuals who frequently disengage these restraints have been found to “experience low guilt over harmful conduct, are less prosocial, and are more prone to vengeful rumination” (Bandura, 2001, p.9). These characteristics fit into the Hare Psychopathy Checklist, as discussed previously in this paper.

In this way, social cognitive theory does take into account many, but not all, of the factors discussed in the body of this paper, however it is difficult to disentangle these crimes from the gangland background to which they belong. In the specific case of Irish gangland killings, it is especially difficult to elucidate the motives involved, as there is so little empirical evidence available; therefore caution is advised in judging the causes of such crime. It is also worthwhile to consider the importance of multidisciplinary research on this topic, as the wide variety of factors involved may be best understood by different disciplinary knowledge before synthesised. By crossing the traditional boundaries of the knowledge disciplines and consolidating a body of work, an appropriately complex model may be developed to adequately account for this uniquely Irish phenomenon.

Social cognitive theory, from an agentic perspective, also posits that sociostructural factors such as economic conditions, socioeconomic status, and family structure do not affect an individual’s behaviour di-

Conclusion

128 Student Psychology Journal, Volume IV BYRNE The central argument set out in this paper is that it is impossible, at present at least, to isolate the sole or most important motivating factor behind gangland killings. Rather, it is most likely that some or all of the factors discussed above operate in conjunction in motivating such crime; as organised crime is both complex and multifaceted, as Levi (1998) claimed, the motives behind gangland homicide, a result of organised crime, are similarly complex. Although the agentic perspective on social cognitive theory offers some theoretical insight to the phenomenon, several possible motivating factors are neglected. In order to gain a nuanced and complete understanding of why these crimes are committed, further interdisciplinary research is necessary, after which a suitably complex model of motivation could be developed. â&#x20AC;&#x192; References Abadinsky, H. (2010). Organised crime (9th ed.). Belmont, CA: Cengage Learning. Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology , 52, 1-26. Bandura, A., Ross, D., & Ross, S.A. (1961). Transmission of aggression through imitation of aggressive models. Journal of Abnormal and Social Psychology, 63(3), 575-582. Bandura, A., & Walter, P. (1959). Adolescent aggression. New York: Ronald.

Blau, J., & Blau, P. (1982). The cost of inequality: Metropolitan structure and violent crime. American Sociological Review , 47 (1), 114-129. Buehler, R., Patterson, G., & Furniss, J. (1966). The reinforcement of behaviour in institutional settings. Behaviour Research and Therapy , 4, 157-167. Campbell, L. (2008). Organised crime, anonymous witnesses and fair trials in Ireland: Responding to R v Davis. International Commentary on Evidence , 6 (1). Campbell, L. (2008). The culture of control in Ireland: Theorising recent developments in criminal justice. Web Journal of Current Legal Issues , 1. Campbell, L. (2010). Responding to gun crime in Ireland. British Journal of Criminology , 50, 414-434. Coleman, C., & Norris, C. (2000). Introducing criminology. Devon: Willan. Connolly, J. (2006). Drugs and crime in Ireland. Overview 3. Dublin: Health Research Board. Davey, E. (2008, September). Organised crime in Ireland: A policy analysis of the introduction of organised crime to the Irish statute book. Retrieved December 5, 2012, from Dublin Insitute of Technology: http://arrow.dit.ie/cgi/ viewcontent.cgi?article=1006&context=aaschssldis

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ORGANISED CRIME AND GANAGLAND KILLINGS Decker, S., & van Winkle, B. (1996). Life in the gang: Family, friends and violence. New York: Cambridge University Press. Department of Justice and Equality. (2012). Organised crime. Retrieved December 5, 2012, from Department of Justice and Equality: http://www. justice.ie/en/JELR/Pages/Organised_ crime Eysenck, H., & Gudjonsson, G. (1989). The causes and cures of criminality. New York: Plenum Press. Gottfredson, M., & Hirschi, T. (1990). A general theory of crime. Retrieved December 5, 2012, from Google Books: http://books.google. ie/books?hl=en&lr=&id=loNPs7n94p0C&oi=fnd&pg=PR13&d q=gottfredson+%26+hirschi+a+general+theory+of+crime&ots=H4YrD_ PpW7&sig=uofrO62McvxB0ECx_ xaielMBuCY&redir_esc=y Hare, R., Clark, D., Grann, M., & Thornton, D. (2000). Psychopathy and the predictive validity of the PCL-R: An international perspective. Behavioural Sciences and the Law , 18, 623-645. Hollenberg, E., & Sperry, M. (1951). Some antecedents of aggression and effects of frustration in doll play. Personality , 1, 32-43. Howitt, D. (2009). Introduction to forensic and criminal psychology. Essex, England: Pearson Education Limited. Jamel, J. (2008). Crime and its causes. In G. Davies, C. Hollin, & R. Bull (Eds.),

Forensic psychology (pp. 1-28). Chichester: John Wiley & Sons. Kleemans, E. (2007). From due process to crime control: The decine of liberalism in the Irish criminal justice system. Irish Law Times , 5 (1), 5-12. Klein, M., & Maxson, C. (1989). Street gang violence. In N. Weiner (Ed.), Violent crimes, violent criminals (pp. 198-234). Beverly Hills: Sage. Lally, C. (2012, August 23). Decline in organised crime confirms recession has been bad for business. Retrieved December 5, 2012, from The Irish Times: http://www. irishtimes.com/newspaper/ireland/2012/0823/1224322767764. html Levi, M. (1998). Perspectives on â&#x20AC;&#x2DC;organised crimeâ&#x20AC;&#x2122;: An overview. The Howard Journal , 37 (4), 335-345. McCarthy, B., Hagan, J., & Cohen, L. (1998). Uncertainty, cooperation, and crime: Understanding the decision to co-offend. Social Forces , 77 (1). Meade, J. (2000). Organised crime, moral panic, and law reform: The Irish adoption of civil forfeiture. Irish Criminal Law Journal , 10 (1), 11-16. Mealey, L. (1995). The sociobiology of sociopathy: An integrated evolutionary model. Behavioural and Brain Sciences , 18, 523-599.

130 Student Psychology Journal, Volume IV BYRNE Menta, P., & Beer, J. (2009). Neural mechanisms of the testosterone-aggression relation: The role of the orbitofrontal cortex. Journal of Cognitive Neuroscience , 22 (10), 2357-2368. Miles, D., & Carey, G. (1997). Genetic and environmental architecture of human aggression. Journal of Personality and Social Psychology , 72 (1), 207-217. Miller, W. (1958). Lower class culture as a generating milieu of gang delinquency. Journal of Social Issues , 14, 5-19. Moffitt, T. (1993). Adolescence-limited and life-course-persistent antisocial behaviour: A developmental taxonomy. Psychological Review , 100 (4), 674-701. O’Donnell, I. (2005). Violence and social change in the Republic of Ireland. International Journal of the Sociology of Law , 33, 101-117. O’Mahony, P. (2000). Prison policy in Ireland: Criminal justice versus social justice. Undercurrents Series. Cork: Cork University Press. O’Mahony, P. (2008). The Irish war on drugs: The seductive folly of prohibition. Manchester: Manchester University Press. Palmer, E. (2008). Contemporary psychological contributions to understanding crime. In G. Davies, C. Hollin, & R. Bull (Eds.), Forensic psychology (pp. 29-56). Chichester: John Wiley & Sons. Parker, R., & Auerhahn, K. (1998). Alco-

hol, drugs, and violence. Annual Review of Sociology , 24, 291-311. Pistone, J., & Woodley, R. (1988). Donnie Brasco: My undercover life in the mafia. New York: New American Library. Rajender, S., Pandu, G., Sharma, J., Ghandi, K., Singh, L., & Thangaraj, K. (2008). Reduced CAG repeat length in androgen receptor gene is associated with violent criminal behaviour. International Journal of Legal Medicine , 122, 367-372. Reuter, P. (1983). Disorganised crime: The economics of the visible hand. Cambridge, Massachusetts: MIT Press. Schelling, T. (1984). Choice and consequence. Cambridge, Massachusetts: Harvard University Press. Short, J. J. (1968). Gang delinquency and delinquent subcultures. New York: Harper & Row. Tuvblad, C., Grann, M., & Lichtenstein, P. (2006). Heritability for adolescent antisocial behaviour differs with socioeconomic status: Gene-environment interaction. Journal of Child Psychology and Psychiatry , 47 (7), 734-743. Vaughn, M., Delisi, M., Beaver, K., & Wright, J. (2009). DAT1 and 5HTT are associated with pathological criminal behaviour in a nationally representative sample of youth. Criminal Justice and Behaviour , 36 (11), 11131124.

Review articles ORGANISED CRIME AND GANAGLAND KILLINGS von Lampe, K., & Johansen, P. (2004). Organized crime and trust: On the conceptualisation and empirical relevance of trust in the context of criminal networks. Global Crime , 6 (2), 159-184. White, H., & Gorman, D. (2000). Dynamics of the drugs-crime relationship. Criminal Justice , 1, 151-218. Wright, A. (2006). Organised crime. Cullompton: Willan Publishing.

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Student Psychology Journal, 2013, 132-143

Are the Primary Sensory Cortices Multisensory? Ciara Devine Trinity College, Dublin Correspondence: devineca@tcd.ie

abstract

Historically the brain has been viewed as operating in a modular and hierarchical manner. In particular it was previously assumed that each of the primary sensory cortices processed input from a single sensory modality before feeding this information to higher regions of the brain devoted to multisensory integration. This review however outlines a wealth of findings that have emerged in recent years to suggest that in fact the primary sensory cortices are multisensory and that multisensory integration takes place much earlier in the brain than once believed. These findings have given rise to a shift in how the brain and the sensory systems are viewed, as well as methodological and theoretical debates surrounding these revolutionary findings. Introduction Multisensory interactions are a major feature of and requirement for everyday human perception. The brain needs to be able to integrate a wealth of information coming from various different sensory modalities in order to create a coherent representation of the world. Previous models asserted that crossmodal interactions occurred in higher-level multisensory convergence regions of the brain only after extensive processing of unisensory information in lower regions of the brain. The superior temporal sulcus (STS) and intraparietal sulcus (IPS) are two such regions

that have been consistently identified as being â&#x20AC;&#x2DC;heteromodalâ&#x20AC;&#x2122; (Calvert, 2001; Driver & Noesselt, 2008). However, findings in recent years have led to a radical shift away from this viewpoint with evidence now suggesting that multisensory interactions take place much earlier on, in areas of the brain that were once considered unimodal such as the primary sensory cortices. Thus the focus of this review is on examining evidence relating to crossmodal interactions occurring early on in the primary sensory cortices of the human brain and how consequential these interactions are for perception.

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ARE THE PRIMARY SENSORY CORTICES MULTISENSORY Principles of multisensory interaction It is important to note that much of this research has been inspired by the pioneering work of Stein and Meredith (1993) who uncovered the main principles governing multisensory processing in single neurons of the superior colliculus (SC) in cats. They demonstrated that many SC neurons respond to input from multiple sensory modalities. These neurons exhibit supraadditive effects whereby they fire significantly more in response to multisensory input than would be predicted by summing together their unimodal responses. Furthermore, such multisensory gains are greatest when the input from each modality is weak, a principle known as the law of inverse effectiveness. These principles have come to guide researchers in investigating human multisensory processing. According to Calvert, Hansen, Iversen and Brammer (2001) response enhancement has become a hallmark feature of multisensory interaction. Crossmodal interactions in primary sensory cortices Using neuroimaging techniques such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), evidence of crossmodal interactions in the normal human brain, in line with the principles outlined above, has been demonstrated in the primary sensory cortices. A number of studies have demon-

strated evidence of audio-visual interactions, showing that the primary visual cortex (V1) is activated in response to simple auditory tones whilst the primary auditory cortex (A1) is activated to simple visual stimuli such as checkerboard patterns and flashes (Martuzzi et al., 2007; McIntosh, Cabeza & Lobaugh, 1998; Noesselt et al., 2007). Audio-visual speech interactions have also been reported in the form of A1 activation during silent lip-reading, indicating that visual speech information can activate A1 in the absence of auditory speech information (Calvert et al., 1997; Pekkola et al., 2005). Sathian, Zangaladze, Hoffman and Grafton (1997) reported evidence also of visuo-tactile interactions in V1. In their PET study, increased blood flow was observed in V1 of sighted participants that were required to judge the orientation of tactile gratings presented to their fingertips. Thus, in contrast to traditionally modular views of the brain, it appears that the primary sensory cortices can be activated to input coming from non-dominant modalities, although it is important to be aware that these activations are weaker than those that occur in response to information from the dominant sense (Martuzzi et al., 2007). Crossmodal interactions in the form of supraadditive effects have also been demonstrated. Martuzzi et al. (2007) reported greater activation in both A1 and V1 under audio-visual conditions, where checkerboard patterns and auditory tones

134 Student Psychology Journal, Volume IV DEVINE were presented simultaneously, compared to unimodal conditions where they were presented independently. This finding has been supported by other audio-visual investigations involving simple stimuli (Meienbrock, Naumer, Doehrmann, Singer & Muckli, 2007; Watkins, Shams, Tanaka, Haynes & Rees, 2006) and speech related stimuli (lip movements and speech sounds) presented congruently (Calvert et al., 1999; Calvert, Campbell & Brammer, 2000; Calvert et al., 2001). Furthermore, Macaluso, Frith and Driver (2000) reported supraadditive effects under visuo-tactile conditions whereby tactile stimulation applied to the same hand towards which vision was being directed resulted in enhanced V1 activation. Thus there is evidence of enhanced neural activation in the primary sensory cortices under congruent multisensory conditions. Methodological debate However, a number of constraints relating to neuroimaging techniques have been highlighted. Despite its superior spatial resolution compared to other methods, fMRI measurements are still very limited with each voxel measuring the activity of millions of neurons within the same region (Calvert, 2001). Thus the neuroimaging findings reported here cannot be used to infer that multisensory integration is taking place at the neuronal level, as reported in the superior colliculus (Stein & Meredith, 1993). Rather, these findings could be ac-

counted for by the coexistence of unimodal neurons responding to different modalities in the same cortical area (Calvert, 2001). Furthermore, Laurienti, Perrault, Stanford, Wallace and Stein (2005) highlighted that in some cases large fMRI voxels may be detecting activation in multisensory convergence zones that lie beyond or outside of the primary sensory regions. Klemen and Chambers (2012) stated that our understanding of multisensory processing is constrained by insufficient spatial resolution in many neuroimaging techniques and by the inability of researchers to carry out invasive recording with healthy humans to measure interactions at the neuronal level. Although recent evidence in support of early audio-visual interactions at the neuronal level has emerged from studies on epileptic patients that have intracranial electrodes implanted in A1 (Besle et al., 2008; Reale et al., 2007), such evidence is limited to patient populations. Are the primary sensory regions truly interacting? There has been debate in the literature as to whether or not early primary sensory interactions reflect genuine communication between the primary sensory regions or feedback from higher order regions of the brain that underlie higher cognitive abilities. The role of mental imagery

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ARE THE PRIMARY SENSORY CORTICES MULTISENSORY One possibility is that early primary visual activation is linked to mental imagery (MI) rather than direct interaction between the sensory systems. In Kosslyn and Thompsonâ&#x20AC;&#x2122;s (2003) review it emerged that V1 is activated not only during visual perception but also during MI tasks involving the recall or imagination of shapes. For example, Slotnick, Thompson and Kosslyn (2005) reported V1 activation when participants were asked to imagine a checkerboard stimulus that they had previously been presented with. Furthermore transcranial magnetic stimulation (TMS) studies suggest that V1 may even be crucial for MI (Kosslyn et al., 1999). Such findings have led to the suggestion that MI rather than actual bimodal sensory integration could account for early crossmodal effects (Driver & Noesselt, 2008). From this viewpoint, auditory and tactile sensory information may not be directly processed in V1 but rather non-visual sensory input may elicit mental imagery that in turn gives rise to V1 activation. An example of this comes from Sathian et al. (1997) who suggested that tactile grating stimuli might give rise to visuospatial images that account for V1 activation during tactile perception. Crucial insight into the MI debate comes from studies of congenitally blind individuals who have never had any visual experience and therefore presumably lack the capacity for visual MI. Such studies have reported activation of V1 during

braille reading (Burton, McLaren & Sinclair, 2006; Sadato et al., 1996; 1998) and during auditory speech processing tasks (Burton, Snyder, Diamond & Raichle, 2002; Roder, Stock, Bien, Neville & Rosler, 2002) for congenitally blind participants and participants who became blind early in life prior to gaining much visual experience. Similar V1 activation has also been reported for an early blind individual during echolocation (Arnott, Thaler, Milne, Kish & Goodale, 2013). This implies that MI is not entirely responsible or necessary for crossmodal activation in V1, even though MI does activate V1 in healthy individuals. Furthermore, these findings demonstrate the inherent plasticity of the sensory systems in adapting to different sensory experiences (Renier, DeVolder & Rauschecker, in press). The fact that V1, which is predominantly specialised for visual processing under normal developmental circumstances, can take on a role in processing auditory and tactile information in the absence of visual input provides unique insight into the multisensory nature of this brain region. These findings indicate that the capabilities of V1 are not limited solely to the processing of visual sensory information. Moreover, MI cannot account for V1 activation reported in these studies. Going forward researchers should seek to distinguish between activation related directly to sensory processing as opposed to MI. In higher-level visual areas

136 Student Psychology Journal, Volume IV DEVINE such as the lateral occipital complex, which is devoted to object recognition, researchers have found that imagining tactile stimuli elicits weaker activation than actually perceiving those stimuli (Amedi, Malach, Hendler, Peled & Zohary, 2001). Similar studies could be carried out comparing V1 activation during actual crossmodal perception as compared to during MI tasks in order to provide greater insight into the role of MI in early primary sensory interactions. Attentional feedback Another possibility is that higher regions of the brain, involved in guiding attention modulate crossmodal interactions by processing input from one modality and sending feedback to primary sensory regions related to another sensory modality. In support of this, measures of directional functional connectivity have produced strong evidence that in the human brain, A1 and V1 are directly influenced by projections from the STS with very little direct connectivity between A1 and V1 (Noesselt et al., 2007). Furthermore, Meienbrock et al. (2007) argued that enhanced V1 activation in response to spatially incongruent audio-visual stimuli may be caused by signals from heteromodal regions, such as the STS and IPS, which detect sensory mismatch and send signals to the V1 in order to redirect attention towards resolving this incongruency. However, most cases of early multisensory interactions reported

here have involved congruent rather than incongruent crossmodal stimulation. Arguing against the role of attentional processes in early primary sensory interactions, Merabet et al. (2006) reported V1 activation during a tactile discrimination task alongside deactivation of the extrastriate cortex, as opposed to enhanced extrastriate activity, which the authors stated is typically associated with attentional processes. Watkins, Shams, Josephs and Rees (2007) also argued against attentional feedback based on their findings of V1 enhancement during the flash illusion, whereby one flash is perceived as two as a result of hearing two auditory tones, and V1 suppression in a contrasting illusion, whereby two flashes are perceived as one as a result of hearing only one auditory tone. If a general attentional process mediated V1 activation then these differences should not have occurred. In both of these studies, activation patterns that would be expected if attentional processes were responsible for early V1 activation were not observed. Early electrophysiological interactions Some of the strongest evidence that genuine multisensory interactions occur very early on in sensory processing comes from studies using electroencephalography (EEG) and magnetoencephalography (MEG). These recording techniques, although they have poor spatial resolution

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ARE THE PRIMARY SENSORY CORTICES MULTISENSORY (Calvert, 2001), allow researchers to gain precise temporal information about early activity in cortical cell populations that are linked to both unisensory and multisensory processes (Besle, Bertrand & Giard, 2009; Besle, Fort & Giard, 2004). Giard and Peronnet’s (1999) pioneering study provided the earliest evidence of supraadditive effects occurring at very early latencies over right occipito-parietal regions of the scalp. In their study, participants were required to recognise objects based on audio, visual or audio-visual features. Larger event-related potentials (ERPs), which could not be predicted by summing unimodal ERPs, were recorded as early as 40ms post-stimulus onset in the audio-visual condition along with behavioural facilitation in the form of superior object recognition performance. Similar results have been reported under audio-visual conditions for simple object detection tasks (Fort, Delpuech, Pernier & Giard, 2002; Molholm et al., 2002) and even in the absence of any task (Vidal, Giard, Roux, Barthelemy & Bruneau, 2008), as well as under audio-somatosensory conditions (Foxe et al., 2000). These interactions correspond in terms of latency and topography to ERP components such as the visual P1 and auditory N1, which are associated with early unisensory processing. Studies using illusions have also demonstrated very early crossmodal interactions. Visual ERP signals are modulated by auditory input as early as 35ms post

stimulus onset during the flash illusion (Bhattacharya, Shams & Shimojo, 2002; Shams, Iwaki, Chawla & Bhattacharya, 2005; Shams, Kamitani, Thompson & Shimojo, 2001). The principle of inverse effectiveness has also been investigated in relation to early latency crossmodal interactions. Senkowski. Saint-Amour, Hofle and Foxe (2011) found evidence of audio-visual interactions at 40–60ms when auditory tones and visual gratings were presented at low but not moderate or high intensity levels. In line with this principle, schizophrenia patients, who display natural neurophysiological deficits in unisensory processing, demonstrate greater ERP enhancements than control participants during audio-visual conditions (Stone et al., 2011). This is in line with the notion that multisensory interactions are more beneficial when unisensory signals or processes are insufficient for stimulus detection or recognition. Researchers argue that these ERP enhancements under crossmodal conditions occur too early to be modulated by topdown signals, such as those relating to attention or MI. In Mottonen, Schurman and Sams’ (2004) audio-visual speech peception study, modulation of the auditory N1 component by visual information relating to lip movements occurred between 150– 220ms, much earlier than interactions occurring in the STS between 250–600ms. Additionally, Molholm et al. (2002) repor-

138 Student Psychology Journal, Volume IV DEVINE ted that direct connectivity between A1 and V1 is possible given that auditory signals are detected at 15ms, much earlier than visual signals, thereby allowing sufficient time for A1 to project information to V1 in order for integration to take place. Thus early electrophysiological interactions provide indirect evidence in support of the existence of monosynaptic projections between the primary sensory cortices, which to date have only been demonstrated directly in animal tracing studies (Clavagnier et al., 2004; Falchier, Clavagnier, Barone, & Kennedy, 2002; Rockland & Ojima, 2003). Methodological issues Although electrophysiological research appears to offer strong support for genuine early multisensory interactions, artefacts may confound these results. Teder-Salejarvi, McDonald, DiRusso and Hillyard (2002) reported evidence of a slow-wave anticipatory potential appearing before stimulus-onset that could account for significant bimodal interactions occurring around 40ms. After filtering the EEG data they reported that true audio-visual interactions might not occur in visual areas until 130ms. According to Driver and Noesselt (2008), very few EEG studies manage to avoid this particular confound, which could indicate that the seemingly strong electrophysiological evidence for early multisensory interactions occurring simultaneously with unisensory process-

ing may merely be the product of methodological confounds. However, some studies have found evidence of genuine early audio-visual interactions when accounting for anticipatory potentials (Klucharev, Mottonen & Sams, 2003; Shams, Iwaki, Chawla & Bhattacharya, 2005). Nevertheless, in using these measures, researchers need to be aware of neural activity and artefacts that may produce extraneous results. Functional relevance of early interactions A final question that surrounds early multisensory interactions is whether or not they have an impact on actual perception or merely constitute an epiphenomenon. Numerous studies suggest that crossmodal interactions in the primary sensory cortices are functionally relevant. Researchers investigating the flash illusion have reported greater V1 activation only when participants consciously report experiencing two flashes as opposed to one (Watkins et al., 2006; Shams et al., 2005). This suggests that activity at the neural level is linked to perceptual experiences. In another interesting study, Theoret, Merabet and Pascual-Leone 2004) blindfolded sighted participants who then learned how to read braille letters. Following five days of training the researchers observed increased V1 activation in response to braille that corresponded with increased braille reading abilities. Furthermore, both V1 activation

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ARE THE PRIMARY SENSORY CORTICES MULTISENSORY and behavioural improvements disappeared following blindfold removal thereby indicating that the recruitment of V1 was functionally related to behavioural facilitation effects. A more recent replication of this study found that enhanced braille reading performance was disrupted when TMS was applied to V1 (Merabet et al., 2008). In an earlier study Zangaladze, Epstein, Grafton and Sathian (1999) also applied TMS to V1 in sighted participants and found that they showed impaired performance during a tactile orientation discrimination task. TMS studies provide even stronger support for the functional role of V1 in early crossmodal interactions. In offering a rationale for why some early interactions may take place in V1, Molholm et al. (2002) suggested that they serve an evolutionary function in facilitating rapid detection of stimuli. In support of this, Van der Burg, Talsma, Olivers, Kickey and Theeuwes (2011) found that participants were faster to locate transforming target visual stimuli among distractors when the transforming target was paired with an auditory tone. Furthermore, the strength of the underlying ERP signals occurring at 50-60ms post stimulus onset correlated with search-time benefits in this study. It is possible that our ancestors relied upon rapid integration of information from different modalities so as to detect threatening stimuli in the environment that may not be easily detected under unimodal conditions, thus giving rise to the evo-

lution of early multisensory capabilities. However, as pointed out by Watkins et al. (2006), despite evidence of early functional interactions, researchers do not yet have a thorough understanding of their consequences for perception. Conclusion In summary, this review has demonstrated that crossmodal interactions are not limited to higher-level, multisensory convergence zones and in fact take place much earlier on in lower regions of the brain. There is strong evidence suggesting that these interactions are the consequence of direct projections and communication between the primary sensory cortices. Furthermore, early interactions appear to play a functional role in conscious perception although continued research is required in order to fully understand these perceptual consequences. Due to methodological limitations associated with both neuroimaging and electrophysiological recording techniques, human research may continue to rely on animal studies to provide frameworks for multisensory integration at the neuronal level as it is not yet possible to assess this in healthy humans. References Amedi, A., Malach, R., Hendler, T., Peled, S., & Zohary, E. (2001). Visuo-haptic object related activation in the ventral visual pathway. Nature Neuroscience, 4, 324 â&#x20AC;&#x201C; 330.

140 Student Psychology Journal, Volume IV DEVINE Arnott, S. R., Thaler, L., Milne, J., Kish, D., & Goodale, M. A. (2013). Shape-specific activation of occipital cortex in an early blind echolocation expert. Neuropsychologia, 51(5), 938 – 949. Besle, J., Bertrand, O., Giard, M. (2009). Electrophysiological (EEG, sEEG, MEG) evidence for multiple audio-visual interactions in the human auditory cortex. Hearing Research, 258, 143 – 151. Besle, J., Fischer, C., Bidet-Caulet, A., Lecaignard, F., Bertrand, O., & Giard, H. (2008). Visual activation and audio-visual interactions in the auditory cortex during speech perception: Intracranial recordings in humans. The Journal of Neuroscience, 28(52), 14301 – 14310. Besle, J., Fort, A., & Giard, M. (2004). Interest and validity of the additive model in electrophysiological studies of multisensory interactions. Cognitive processing, 5(3) 189 – 192. Bhattacharya, J., Shams, L., & Shimojo, S. (2002). Sound-induced illusory flash perception: Role of gamma band responses. NeuroReport, 13, 1727 – 1730. Burton, H., McLaren, D. G., Sinclair, R. J. (2006). Reading embossed capital letters: An fMRI study in blind and sighted individuals. Human Brain Mapping, 27, 325 – 339. Burton, H., Snyder, A. Z., Diamond, J. B., Raichle, M. E. (2002). Adaptive changes in early and late blind: A fMRI study of very generation to

heard nouns. Journal of Neuophysiology, 88, 3359 – 3371. Calvert, G. A. (2001). Crossmodal processing in the human brain: Insights from functional neuroimaging studies. Cerebral Cortex, 11, 1110 – 1123. Calvert, G., Brammer, M., Bullmore, E., Campbell, R., Iversen, S., & David, A. (1999). Response amplification in sensory-specific cortices during crossmodal binding. NeuroReport, 10, 2619 – 2623. Calvert, G. A., Campbell, R., & Brammer, M. J. (2000). Evidence from functional magnetic resonance imaging of crossmodal binding in the human heteromodal cortex. Current Biology, 10, 649 – 657. Calvert, G., Bullmore, E., Brammer, M., Campbell, R., Williams, S., McGuire, P., Woodruff, P., Iversen, S., & David, A. (1997). Activation of auditory cortex during silent lip reading. Science, 276, 593 – 596. Calvert, G., Hansen, P., Iversen, S., & Brammer, M. (2001). Detection of audio-visual integration sites in humans by application of electrophysiological criteria to the BOLD effect. NeuroImage, 14, 427 – 438. Clavagnier, S., Falchier, A., & Kennedy, H. (2004). Long-distance feedback projections to area V1: Implications for multisensory integration, spatial awareness, and visual consciousness. Cognitive, Affective & Behavioural Neuroscience, 4, 117 – 126.

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Student Psychology Journal, 2013, 144-154

A critical Examination of the Effectiveness of Pharmacological Intervention for Challenging Behaviour in Individuals with Intellectual Disabilities. Áine Maguire Trinity College, Dublin Correspondence: afmaguir@tcd.ie

abstract

Challenging behaviour can frequently have a detrimental effect on the quality of life of persons with intellectual disabilities and those around them. Given the often recurrent nature of challenging behaviours, it is necessary to employ management strategies to reduce negative effects. One common intervention strategy is the use pharmacological agents to minimize the behaviour’s impact, often in the absence of mental illness. This paper considers the effectiveness of three psychotropic medications (antipsychotics, anticonvulsants and antidepressants) that are commonly used to manage challenging behaviour. It is apparent that the extent to which such interventions can ameliorate challenging behaviour is questionable. Introduction to challenging behaviour Challenging behaviour has been defined as “culturally abnormal behaviour(s) of such an intensity, frequency or duration that the physical safety of the person or others is likely to be placed in serious jeopardy, or behaviour which is likely to seriously limit use of, or result in the person being denied access to, ordinary community facilities” (Emerson, 1995; as cited by Emerson, 2001). Chal-

lenging behaviour includes for example verbal and physical aggression, disruptive and antisocial behaviour, screaming and temper tantrums, self-injurious behaviour, and property damage and destructiveness (Heyvaert et al., 2010). The development of challenging behaviour can be influenced by the presence of mental illness (Grey, Pollard, McClean, MacAuley & Hastings, 2010) and by the dynamic relationship between

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PHARMACOLOGICAL INTERVENTIONS AND INTELLECTUAL DISABILITIES person- and environment-oriented factors, including skill level with regard to language and problem solving (van Nieuwenhuijzen,, de Castro, Wijnroks, Vermeer, & Matthys, 2009), adaptive and social abilities (Kearney & Healy, 2011), coping skills and exposure to stress (Janssen, Schuengel, & Stolk, 2002). Challenging behaviours are especially prevalent in individuals with intellectual disabilities, and disability severity is a strong predictor of challenging behaviour presence, including those without comorbid mental illness (Heyvaert, et al., 2010). Challenging behaviours can have a detrimental effect on the person with the intellectual disability, their family, and involved services, becoming a continuous and sometimes dangerous battle due to the recurrent and occasionally violent nature of the behaviour (Heyvaert et al., 2010; Mills & Rose, 2011). Challenging behaviours may lead to a reduction in quality of life, impede social integration, and become a gross expense to the individual and society with regard to staffing and residential care when necessary (Emerson, 2001). Managing challenging behaviour Given the consequences of challenging behaviour for the individual and those around them it is necessary to employ effective strategies to help reduce, control, or eradicate the behaviour. International guidelines recommend that the underlying

cause of the challenging behaviour should be identified and addressed as the main goal of behavioural management. When it is not possible to find a cause, the management strategy should aim to minimise the impact of the behaviour on the person, other people and the environment around the individual (Deb et al., 2009). Such management strategies range from biological to contextual interventions, with varying degrees of and evidence for efficacy. It has been observed that people with intellectual disabilities are regularly prescribed psychotropic medication as a form of intervention for challenging behaviour, often in the absence of psychiatric symptoms (Antonacci, Manuel & Davis, 2008). This has been a cause for concern for over twenty years amidst claims that people with intellectual disabilities are one of the most medicated groups in society (McGillivray & McCabe, 2004). It has also been suggested that medication is often prescribed due to limited resources and an inability to meaningfully change the surrounding environment, in response to calls from nursing and care staff as an immediate solution, and as an alternative to adequate numbers of trained staff (Marshall, 2004). Despite widespread use of such pharmacological interventions for challenging behaviours there is little empirical evidence on their effectiveness (Grey & Hastings, 2005). Ideally, appropriate empirical

146 Student Psychology Journal, Volume IV MAGUIRE evidence would meet Sprague and Werryâ&#x20AC;&#x2122;s (1971) set of methodological criteria for scientific confidence in pharmacological investigation: placebo control, random assignment of subjects, the use of double blind subjects, standardised dosages, standardised evaluations, and appropriate statistical analyses. Further, McGrath (2010) considers effectiveness, with reference to pharmacotherapy, as whether it works in the real world or not. Work can be described as the ability of the intervention to bring about desired changes without excessive costs. Thus, pharmacological interventions may be considered effective when they reduce challenging behaviours with limited adverse side effects, ultimately making a positive contribution to person quality of life. This evidence ought to come from methodologically sound investigations. While a wide range of pharmacological agents have been prescribed to people with intellectual disabilities, antipsychotic medications appear to be used most often in the United States, the United Kingdom and Australia as an intervention for problem behaviour (McGillivray & McCabe, 2004). Other types of medication used as interventions include anticonvulsants, antidepressants, and mood stabilizers (Antonacci et al., 2008; Deb, 2006). Antipsychotics as interventions for challenging behaviour

It has been claimed that antipsychotics are perhaps the most common medication used for suppressing the challenging behaviour of people with severe disabilities (McGillivray & McCabe, 2004), yet their use and apparent effectiveness have been reported to be by chance, rather than clear neurological explanation (Kennedy & Meyer, 1998). Antipsychotics can elicit variable treatment responses and effects between individuals. Kennedy & Meyer (1998) point to the potential artifactual effects of antipsychotic medication. They suggest a theoretical basis for the variation in effectiveness of antipsychotic medication on challenging behaviour, noting that operant conditioning may play an adjacent role. With reference to Heyman and Monaghan (1987) it was observed that antipsychotics can have a differential effect based on the density of reinforcement; the suppressive effects of these drugs are inversely related to the density of reinforcement, indicating that the less dense a schedule, the greater the rate reduction of challenging behaviour (Kennedy & Meyer, 1998). It is further reported that both typical and atypical antipsychotic medications are used for the management of challenging behaviour in individuals with learning disabilities, with differing degrees of effectiveness and adverse effects (Deb, 2006). Typical antipsychotics used to manage challenging behaviours in individuals with intellectual disabilities include chlorpro-

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PHARMACOLOGICAL INTERVENTIONS AND INTELLECTUAL DISABILITIES mazine, haloperidol and thioridazine. Slight improvement in rates of stereotypy behaviours in individuals with intellectual disabilities have been observed with the use of haloperidol (Aman, Teehan, White, Turbott, & Vaithianathan, 1989). This study employed a double blind placebo cross-over design. Participants could also be described as diverse, ranging in age between 13 and 35 with intellectual disabilities ranging from moderate to profound. Improvements were also observed in stereotypy behaviours following intervention with thioridazine (Aman & White, 1988) using a double-blind, placebo controlled design. However, Matson and Nealâ&#x20AC;&#x2122;s (2009) review highlights an overall absence of methodological rigour with regard to the use of typical antipsychotic agents against challenging behaviours in the literature, particularly with consideration to random assignment of subjects, standardised dosages, and standardised evaluations. These first generation antipsychotics may elicit adverse effects including Parkinsonian symptoms, akathisia and dystonia, and occasionally neuroleptic malignant syndrome and tardive dyskinesia (Deb, 2006). With such serious side effects as these, it is suggested that even if some reduction in challenging behaviour occurs with medication, the drugs do not work, given that the cost exceed the proposed but unreliable benefits, little affecting person quality of life.

As a result of both these methodological queries and prevalent side effects, many practitioners have turned to second generation or atypical antipsychotic drugs in an attempt to control challenging behaviour while limiting adverse extrapyramedal effects (Matson & Mahon, 2010; Ahmed et al., 2000). Atypical antipsychotic medications used to combat challenging behaviour include olanzapine, risperidone, quetiapine, and amisulpiride (Tin, Devapriam, Raju, & Bhaumik, 2008). There have been a small number of randomized control trials which demonstrate some effectiveness of these second generation antipsychotics on challenging behaviours (Ryes et al., 2006; Zarcone et al., 2001) The strongest evidence to support the use of atypical antipsychotic agents for challenging behaviour comes from risperidone. It has been observed that risperidone is effective and well tolerated in both adult and child populations with intellectual disabilities in managing challenging behaviour (Gagiano, Read, Thorpe, Eerdekens, & Van Hove, 2005; Grey & Hastings, 2005). It has also been noted that challenging behaviour, particularly aggression and agitation can be suppressed relatively quickly by risperidone within a child cohort (Deb et al., 2007; Grey and Hastings, 2005). This may explain why Tin and colleagues (2008) observed that risperidone was more frequently prescribed in the management of behaviour problems in moderate to severe/profound intellectual

148 Student Psychology Journal, Volume IV MAGUIRE disability groups than any other atypical antipsychotic. However, as with typical antipsychotics, non-traditional antipsychotics induce adverse events; primarily somnolence and weight gain (Unwin & Deb, 2011) along with higher risk of cerebrovascular accidents (Tin et al., 2008). Despite some evidence to suggest that antipsychotics may help suppress challenging behaviour in individuals with intellectual difficulties, caution must be taken given the shortage of randomized control trials, particularly in adult populations. In two systematic reviews, no trial-based evidence of the effectiveness or ineffectiveness, helpfulness or harmfulness of antipsychotic medication for adults with ID and challenging behaviour was found (Brylewski & Duggan, 1999; Brylewski & Duggan, 2004). Additionally, significant proportion of studies exploring the effectiveness of antipsychotics to date have had significant methodological shortcomings; small sample sizes, poorly defined target behaviours, inappropriate and unvalidated outcome measures, along with a widely variable initial selection criterion (Antonacci et al., 2008). One review by Singh, Matson, Cooper, Dixon, and Sturmey (2005) identified just six studies out of 47 that met the methodological criteria for sound psychopharmacological investigation. It is noted that high medication levels may induce rate reductions as a result of

general sedation rather than response-specific effects (Kennedy & Meyer, 1998). There has been little examination of the effect that somnolence may have on the reduction of challenging behaviour (Grey & Hastings, 2005); does the medication reduce challenging behaviour, or is it that the drowsiness and sedation induced by the agent that inadvertently causes a reduction? This issue must be further explored before it can be accepted that antipsychotics as interventions for challenging behaviour work. Further, Ahmed and colleagues (2000) demonstrated that in a notable proportion of intellectually disabled individuals exhibiting challenging behaviour, antipsychotic medication can be reduced or even withdrawn without significant deterioration of behaviour, indicating that the prolonged prescription of antipsychotics may not be necessary. Tyrer and colleagues (2008) provide key evidence to support the notion that neither old nor new generation of antipsychotics work to reduce challenging behaviour in individuals with intellectual disabilities. In a randomised control trial using both typical and atypical antipsychotics, and a placebo treatment group, it was not only found that there was little difference in treatment effects between typical and atypical antipsychotic medication, but also that the placebo group showed slightly greater improvements than the drug cohorts. The findings illustrate that aggressive challenging behaviour in peo-

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PHARMACOLOGICAL INTERVENTIONS AND INTELLECTUAL DISABILITIES ple with intellectual disability decreases whether or not active medication is given. The authors recommended that routine prescription of even low doses of antipsychotic drugs early in the management of aggressive challenging behaviour should no longer be regarded as a satisfactory form of care (Tyrer et al., 2008). Considering the above research as a whole it may be plausible to suggest that although risperidone may elicit some improvements of challenging behaviour within the first few weeks in children, there is little controlled evidence to support their effectiveness in adults. In addition, antipsychotic medication can induce severe side effects, and given Tyrer and colleagues (2008) finding that patients receiving placebo instead of medication show greater improvements in behaviour, the use of antipsychotics in the absence of psychiatric illness should be spared; although decisions should be made on a case specific basis. Anticonvulsants as interventions for challenging behaviour Listed by the Expert Consensus Guidelines for Treatment of Psychiatric and Behavioral Problems in Individuals with Mental Retardation (2004) as a preferred medication for the treatment of aggression and self-injury, challenging behaviours, anticonvulsant drugs are the second most common psychotropic medi-

cation class prescribed to treat behavioural problems in individuals with intellectual disabilities (Antonacci et al, 2008). However, although some studies have demonstrated a reduction of challenging behaviour, not induced by sedative effects, the behaviour change can only occur with high levels of drug administration (Kennedy & Meyer, 1998). Given the high levels of medication required to induce change, it is little surprise that side effects are common. In some cases Carbamazepine, Vigabatrin, and Topiramate may exacerbate behavioural problems as opposed to improving them (Santosh & Baird, 1999). Additionally anti-epileptic interventions for challenging behaviour can have serious non-behavioural side effects: Carbamazepine may produce a severely itchy albeit benign rash in individuals within the first few weeks of treatment, and although rare, Stevens-Johnson syndrome and toxic epidermal necrolysis can also occur as an effect of treatment; in a small number of individuals sodium valproate can cause liver damage, and there are reports that link it to polycystic ovarian disease (Santosh & Baird, 1999). Topiramate is also associated with adverse effects such as suppression of appetite and has been reported to produce renal stones in 3% of people who take it (Santosh & Baird, 1999). Such adverse effects would be extremely detrimental to person quality of life.

150 Student Psychology Journal, Volume IV MAGUIRE As Kennedy and Meyer (1998) have noted there is little empirical evidence to support the effectiveness of anticonvulsants on challenging behaviours. Interestingly the Monthly Index of Medical Specialties Ireland (2008) makes no reference to the use of anti-epileptics for challenging behaviours, indicating that they should be used solely for the purpose of managing epilepsy and seizures in individuals with intellectual difficulties rather than interventions for challenging behaviours. Given the lack of recent support for the use of anticonvulsants as an intervention for challenging behaviours and their severe adverse effects, it is concluded that they do not work, and their use is only recommended in epileptic patients with intellectual disabilities under strict observation. Antidepressants as interventions for challenging behaviour Practitioners commonly employ antidepressants, specifically selective serotonin re-uptake inhibitors (SSRIs) as a treatment for challenging behaviour among adults with intellectual disabilities (Antonacci et al., 2008; Deb, 2006). These medications have been shown to be effective in reducing irritability and self-injurious behaviour (Antonacci et al., 2008; Deb, 2006), however responses are varied. While Janowski, Shetty, Barnhill, Elamir and Davis (2005) retrospectively observed a marked decrease in self-injurious and destructive behaviours on SSRI

paroxetine, Branford, Bhaumik and Naik (1998) found no significant benefit of either paroxetine or fluoxetine, observing that some patients exhibited a worsening of challenging behaviour. Similar to other medications used for challenging behaviour antidepressants also elicit unpleasant side effects. Paroxetine, though demonstrating some effectiveness on challenging behaviour, can list somnolence, insomnia, tremor, dizziness, and asthenia among its adverse effects (MIMS Ireland, 2008), indicating that it may not be the most beneficial addition to an intervention plan for challenging behaviour Antidepressant medication has shown varying degrees of effectiveness in reducing challenging behaviour, particularly with regard to self-injurious behaviours. However, as with antipsychotic and anticonvulsant medications there is a noticeable lack of stringently controlled trials. Without strong evidence from such trials and in light of the side effects, it is insensible to state that antidepressant interventions for challenging behaviour work. Conclusion As noted by Ulzen & Powers (2008) ) it would be a grave error to attribute challenging behaviours seen in these individuals to their intellectual disability, denying them treatment for what may be may be a coexisting psychiatric illness. Yet large

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PHARMACOLOGICAL INTERVENTIONS AND INTELLECTUAL DISABILITIES numbers of individuals with intellectual disabilities and challenging behaviour who have no conspicuous mental illness receive psychotropic medication (Brylewski & Duggan, 1999). It must also be stressed that brief or self-limiting challenging behaviours, that may reflect physical health problems, or environmental or personal stressors do not merit such prescription (Oâ&#x20AC;&#x2122;Brien & McKinnlon 2009). However, given the prescription prevalence of psychotropic medications for individuals with intellectual disabilities, there is a risk that these medications may be used instead of suitable behavioural interventions in order to avoid excessive resource costs (Ulzen & Powers, 2008; Marshall, 2004). This paper proposes that the evidence in support of the use of pharmacological interventions for challenging behaviours is presently lacking. It observes that such interventions are often associated with imprecise treatment effects and severe side effects. Although certain antipsychotic medications have been shown to reduce challenging behaviour, it is unclear whether this is a drug induced result or as a by-product of the sedative effect. Review studies have also indicated that some forms of anticonvulsant medications may be beneficial; however these treatments are associated with very severe physical side-effects and can on occasion worsen the target behaviours. Antidepressants have also demonstrated some effectiveness in reducing target challenging behaviours, but there is inconsistency in the literature raising doubt over intervention viability.

At present there is no definitive evidence to suggest that pharmacological interventions can ameliorate challenging behaviour. There is a distinct lack of randomized controlled trials for all medications with regard to challenging behaviour. In addition, these behaviours tend to be long lasting and recurrent, yet few studies provide long term follow up for their interventions, therefore it is impossible to know whether there is any long-term benefit to individuals exhibiting challenging behaviour (Deb et al., 2007). It is recommended that pharmacological interventions for challenging behaviours should be used sparingly particularly when no mental illness is present. Should there be no available alternative to pharmacological intervention it is paramount that the extent and form of drug intervention, as well as the characteristics of those who are medicated, be subject to on-going scrutiny, on a case specific basis (McGillivray & McCabe, 2004). References Ahmed, Z., Fraser, W., Kerr, M. P., Kiernan, C., Emerson, E., Robertson, J., & Thomas, J. (2000). Reducing antipsychotic medication in people with a learning disability. British Journal Of Psychiatry, 17642-46. Aman, M., Teehan, C., White, A., Turbott, S., & Vaithianathan, C. (1989). Haloperidol treatment with chronically medicated residents: dose effects on clinical behavior and reinforcement contingencies. American Journal Of Mental Retardation: AJMR, 93(4), 452-460.

152 Student Psychology Journal, Volume IV MAGUIRE Aman, M., & White, A. (1988). Thioridazine dose effects with reference to stereotypic behavior in mentally retarded residents. Journal Of Autism And Developmental D i s o r d e r s , 18(3), 355-366.

medication for the management of problem behaviours in adults with intellectual disabilities. World Psychiatry: Official Journal of The World Psychiatric Association (WPA), 8(3), 181- 186.

Antonacci, D. J., Manuel, C., & Davis, E. (2008). Diagnosis and Treatment of Aggression in Individuals with Developmental Disabilities. Psychiatric Quarterly, 79(3), 225-247.

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Branford D., Bhaumik S. & Naik B. (1998) Selective serotonin re-uptake inhibitors for the treatment of perseverative and maladaptive behaviours of people with intellectual disability. Journal of Intellectual Disability Research 42, 301â&#x20AC;&#x201C;6. Brylewski, J., & Duggan, L. L. (1999). Antipsychotic medication for challenging behaviour in people with intellectual disability: A systematic review of randomized controlled trials. Journal of Intellectual Disability Research, 43(5), 360-371. Brylewski, J., & Duggan, L. (2004). Antipsychotic medication for challenging behaviour in people with learning disability. Cochrane Database of Systematic Reviews, (3). Deb, S. (2006) Medication for behaviour problems associated with learning disabilities. Psychiatry, 5(10), 368371. Deb, S., Kwok, H., Bertelli, M., Salvador-Carulla, L., Bradley, E., Torr, J., & Barnhill, J. (2009). International guide to prescribing psychotropic

Emerson, E (2001). Challenging Behaviour: Analysis and intervention in people with learning disabilities, 2nd edition. Cambridge University Press. Gagiano, C., Read, S., Thorpe, L., Eerdekens, M., & Van Hove, I. (2005). Shortand long-term efficacy and safety of risperidone in adults with disruptive behavior disorders. Psychopharmacology, 179(3), 629-636. Grey, I. M., & Hastings, R. P. (2005). Evidence-based practices in intellectual disability and behaviour disorders. Current Opinion in Psychiatry, 18(5), 469-475. Grey, I., Pollard, J., McClean, B., MacAuley, N., & Hastings, R. (2010). Prevalence of psychiatric diagnoses and challenging behaviors in a community-based population of adults with intellectual disability. Journal of Mental Health Research in Intellectual Disabilities, 3(4), 210-222.

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PHARMACOLOGICAL INTERVENTIONS AND INTELLECTUAL DISABILITIES Heyvaert, M. M., Maes, B. B., & Onghena, P. (2010). A meta-analysis of intervention effects on challenging behaviour among persons with intellectual disabilities. Journal of Intellectual Disability Research, 54(7), 634649. Janssen C. G. C., Schuengel C., & Stolk J. (2002). Understanding challenging behavior in people with severe and profound intellectually disability: A stress-attachment model. Journal of Intellectual Disability Research, 46(6), 445–453 Janowsky D.S., Shetty, M., Barnhill J., Elamir B., & Davis J.M. (2005). Serotonergic antidepressant effects on aggressive, self-injurious and destructive/ disruptive behaviours in intellectually disabled adults: a retrospective, open-label, naturalistic trial. International Journal of Neuropsychopharmacology, 8 (1), 37-48. Kennedy, C. H., & Meyer, K. A. (1998). The use of psychotropic medication for people with severe disabilities and challenging behavior: Current status and future directions. Journal of the Association for Persons With Severe Handicaps, 23(2), 83-97. Marshall, T. (2004). Audit of the use of psychotropic medication for challenging behaviour in ` a community learning disability service. Psychiatric Bulletin, 28(12), 447-450. Matson, J. L., & Mahan, S. (2010). Antipsychotic drug side effects for persons with intellectual disability. Research in Developmental Disabilities, 31(6),

1570-1576. Matson, J. L., & Neal, D. (2009). Psychotropic medication use for challenging behaviors in persons with intellectual disabilities: An overview. Research in developmental disabilities, 30(3), 572-586. McGillivray, J. A., & McCabe, M. P. (2004). Pharmacological management of challenging behavior of individuals with intellectual disability. Research In Developmental Disabilities, 25(6), 523-537. McGrath, R.E. (2010). Evaluating Drug Research. In McGrath, R.E. & Moore, B.A. (Eds.), Pharmacotherapy for Psychologists: Prescribing and Collaborative Roles. Washington: American Psychological Association. Mills, S., & Rose, J. (2011). The relationship between challenging behaviour, burnout and cognitive variables in staff working with people who have intellectual disabilities. Journal of Intellectual Disability Research, 55(9), 844-857. Monthly Index of Medical Specialties, August (2008). Irish Medical Times. O’Brien, G., & McKinnon, I. (2009). Medication in people with learning disability and mental illness. Psychiatry, 8(10), 413–415.

154 Student Psychology Journal, Volume IV MAGUIRE Reyes, M., Buitelaar, J., Toren, P., Augustyns, I., and Eerdekens, M. (2006). A randomised double-blind, placebo-controlled study of Risperidone maintenance treatment in children and adolescents with disruptive behaviour disorder. American Journal of Psychiatry 163, 402-410.

Unwin, G. L., & Deb, S. (2011). Efficacy of atypical antipsychotic medication in the management of behaviour problems in children with intellectual disabilities and borderline intelligence: A systematic review. Research In Developmental Disabilities, 32(6), 2121-2133.

Santosh, P., & Baird, G. (1999). Psychopharmacotherapy in children and adults with intellectual disability. Lancet (North American Edition), 354(9174), 233-242.

van Nieuwenhuijzen, M., de Castro, B., Wijnroks, L., Vermeer, A., & Matthys, W. (2009). Social problem-solving and mild intellectual disabilities: Relations with externalizing behavior and therapeutic context. American Journal On Intellectual And Developmental Disabilities, 114(1), 42-51.

Singh, A. N., Matson, J. L., Cooper, C. L., Dixon, D., & Sturmey, P. (2005). The use of risperidone among individuals with mental retardation: Clinically supported or not? Research in Developmental Disabilities, 26(3), 203-218. Tin, N., Devapriam, J., Raju, L., & Bhaumik, S. (2008). Use of atypical antipsychotics in people with intellectual disability--is it atypical?. British Journal Of Developmental Disabilities, 54(107,Pt2), 101-111. Tyrer, P., Oliver-Africano, P. C., Ahmed, Z., Bouras, N., Cooray, S., Deb, S., & ... Crawford, M. (2008). Risperidone, haloperidol, and placebo in the treatment of aggressive challenging behaviour in patients with intellectual disability: A randomised controlled trial. The Lancet, 371(9606), 57-63. Ulzen, T. P., & Powers, R. E. (2008). A Review of Empirical Evidence of Somatic Treatment Options for the MI/ DD Population. Psychiatric Quarterly, 79(3), 265-273.

Zarcone, J.R., Hellings, J.A., Crandall, K., Reese, R.M., Marquis, J., Fleming, K., Shores, R., Williams, D. and Schroeder, S.R. (2001). Effects of Risperidone on Aberrant Behavior in Persons with Developmental Disabilities: I. A Double-Blind Crossover Study Using Multiple Measures, American Journal on Mental Retardation, 106, 525â&#x20AC;&#x201C;538.

Student Psychology Journal, 2013, 155-163

An Account of the Neural Basis and Functional Relevance of Early Cross-Modal Interactions Nicholas Murray Trinity College, Dublin Correspondence: murrayn6@tcd.ie

Contrary to the previous body of literature, burgeoning research is indicating that cross-modal interactions can occur in brain regions previously considered unisensory and at time frames much earlier that initially thought (Ghazanfar and Schroeder, 2006). This has brought on the suggestion that much of the theoretical frameworks present for perception should be reformulated (Driver and Noesselt, 2008). This article attempts to establish how the perceptual hierarchy may be remodelled to accommodate these early cross-modal interactions, addressing the extent to which such interactions occur, their neural underpinnings and their consequences in perception. Given the vast degree of potential mediators coupled with the wide range of anatomical connections utilized by these interactions, future directions for considered multi-modal research are also discussed. Introduction Long-standing models of perception are currently being challenged in the context of an emerging body of evidence which serves to highlight the occurrence of cross-modal interactions in brain regions previously considered unisensory and at time frames much earlier stages than previously thought (Ghazanfar and Schroeder, 2006). This has prompted the suggestion that many of the present theoretical frameworks of perception should be reformulated (Driver and Noesselt,

2008). In order to assess the validity of such an assertion, it is necessary to establish how the perceptual hierarchy may be remodelled to accommodate these early cross-modal interactions. The establishment of the anatomical substrates of these early cross-modal interactions serves only as a foundation on which greater knowledge can be built. Further questions must be examined in order to provide a more comprehensive picture, such as what stimuli are capable of producing these effects and what is the neural basis for such findings. Only when these questions are

156 Student Psychology Journal, Volume IV MURRAY fully addressed will it be possible to integrate early cross-modal interactions into a more comprehensive model of perception. This paper seeks to examine the extent to which processes and their consequences occur in perception through a progressive overview of research to date, assessing the anatomical evidence supporting the nature of these interactions and their neural underpinnings before advancing to the functional implications of early cross-modal interactions. In considering the extent to which cross modal interactions occur early in the human brain and endeavouring to assess their impact in terms of perception, it is important to define what constitutes cross-modal interaction. This is important, particularly given the degree of semantic confusion that has occurred within the discipline (Stein et al., 2010). In addition, it must be recognised that such a definition subsumes three distinct principles which are necessary for investigation. â&#x20AC;&#x153;At the level of the single neuron, multisensory integration is defined operationally as: a statistically significant difference between the number of impulses evoked by a cross-modal combination of stimuli and the number evoked by the most effective of these stimuli individuallyâ&#x20AC;? (Stein and Meredith, 1993). This illustrates an important distinction between interaction and integration: interaction occurs in circumstances where one modality might affect another without necessarily

always implying a single uniďŹ ed percept. Additionally, it is necessary to recognise that early in this context refers to the time period of neural processes alongside the low-level cortical area in which they occur. On this basis, therefore, both temporal and spatial evidence must be considered. Burgeoning evidence appears to indicate that certain neocortical areas may be involved in such cross-modal interactions. Such research is, however, still in its infancy. In considering the extent to which cross modal interactions occur early in the human brain and attempting to assess their impact in terms of perception, it is imperative that perceptual processes involved are examined on a case by case basis, along with a careful consideration of any potential confounds or interpretative issues in data analysis. Low-Level Multisensory Effects Recent studies have indicated multisensory effects within low-level cortices and at early latencies (Ghazanfar and Schroeder, 2006). In the case of non-human primates, multisensory effects have been identified within primary and adjacent auditory cortices (Lakatos et al., 2007). ). In research involving humans, supra-additive nonlinear responses to multisensory stimuli have been observed to occur within 100ms post-stimulus onset (Giard and Peronnet, 1999) and within primary cortices (Martuzzi et al., 2007). These and similar studies indicate that

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NEURAL BASIS AND RELEVANCE OF CROSS-MODAL INTERACTIONS neural processing in low-level cortices can be modulated by interactions between the senses at specific, early post-stimulus time periods. This structural arrangement has been suggested as being primarily due to the brainâ&#x20AC;&#x2122;s organization, allowing for fast access from all sources (Kotter and Sommer, 2000). In this way, neurons with cross-modal responses serve as information hubs which are capable of modulating multisensory cortical recruitment on receipt of various sensory inputs (Vasconcelos et al., 2011). It would seem reasonable then to conclude that multisensory interactions may be deemed to be speciďŹ c to each individual area. In evaluating the manner in which neural mechanisms mediate these early multisensory effects, it is important to consider their timing and origin and to assess whether, for example, multisensory interactions coincide with the initial feed-forward inputs in an area or with later feedback activity. The early stages of research in this area have focused on identifying links between primary cortical regions and cross-modal interactions. These findings, however, should now serve as the foundations upon which to build a greater understanding of the neural processes underlying such interactions and the overarching perceptual architecture in which they fit. The prevalent hierarchical models of sensory processing postulate that such early cross-modal in-

teractions in primary cortical regions are modulated through feedback inputs.Support for such claims is provided by findings from event-related potential (ERP) based studies which have demonstrated the occurrence of such inputs in monkeys and humans and shown their capacity to cross between sensory modalities (Ghazanfar and Schroeder, 2006). Neural Processes Modulating Interactions A growing body of research indicates, however, that these interactions can additionally be modulated via feed-forward processes. ERPs have shown time effects supporting such postulations, with somatosensory-related activation in A1 region occurring at 9 ms, while auditory activation of the same location was shown to occur at 15 ms (Lakatos, 2007). Similarly, there is evidence of auditory-driven responses at 48 ms within inferior parietal cortex (Schroeder et al., 2004) that represent a potential basis for modulation of early sensory processing within the visual cortex. Although these time effects cannot be considered as conclusive proof for feed-forward mechanisms, the short onset of such effects favours that assumption given that it is considerably unlikely that interactions could be modulated by feedback inputs within such a time frame. Spatial evidence supporting feed-forward mechanisms has been found in monkey studies, with direct lateral projections occ-

158 Student Psychology Journal, Volume IV MURRAY urring from primary and adjacent auditory cortices to early visual cortices (V1/V2) (Falchier et al., 2002). If account is taken of this structure, it would appear that auditory inputs are well placed to impact visual processing. Ghazanfar and Schroeder (2006) have boldly posited that the neocortex may be entirely multisensory. The validity of such a postulation rests on the degree to which interactions are due to feedback or feed-forward inputs (Alias et al., 2010). However, a simple dichotomy whereby primary regions are either multisensory or unisensory in nature may not exist. The answer may lie in the middle ground with the neocortex being bi-modal in nature, and perceptual processes influenced by both feed-forward and feedback processes. This assertion may be supported by the differing modulation patterns found in macaque auditory cortex for audio-tactile co-stimulation compared to audio-visual co-stimulation (Kayser et al., 2007). It would appear to emphasise the fact that sensory processing may not represent a serial progression but rather may be mediated by several parallel and recursive loops (Driver and Noesselt, 2007). Future studies should attempt to clarify the nature of such inputs through testing the sources for potential feedback influences from higher cortical regions to sensory-specific regions. Using an efficient methodological design it may be possible

to cancel the occurrence of such feedback effects to specific sensory regions through transient lesioning or by engaging in transcranial magnetic stimulation (TMS) of the hypothesized critical higher areas, while leaving the sensory-speciďŹ c regions intact, indicating whether the cross-modal interaction is still present in those intact regions (Driver and Noesselt, 2007). Thus providing conclusive proof as to whether feedback or feed-forward inputs serve as the crucial mediator of interactions in primary cortical regions. Stimuli Factors Modulating Interactions Nonetheless despite these findings, studies have failed to consider in depth the nature of the stimulus being presented on such interactions. Evidence indicates that cross-modal interactions in primary brain regions may be modulated by factors such as the temporal and spatial congruence of the stimulus presented (Mishra et al., 2007). Additionally an explicit exploration of the effect of stimulus intensity has not been adequately considered within experimentation, which can serve to hinder theoretical advancement due to methodological differences. Addressing such questions is necessary so as to determine whether such cross-modal interactions across sensory systems are general, automatic processes or whether they may be modulated by stimulus-specific processes (Martuzzi et al., 2007). Given the vast array of stim-

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NEURAL BASIS AND RELEVANCE OF CROSS-MODAL INTERACTIONS uli experienced in the environment this serves as a necessary avenue for exploration in order to provide greater clarity on the functional nature of such interactions. Additionally a gap in the research is that most studies have solely considered interactions following the presentation of meaningful stimuli (Martuzzi et al., 2007), an avenue for future research is examining whether such processes may be elicited through the presentation of basic, meaningless stimuli. Despite the growing body of evidence surrounding early cross-modal interactions, several studies have failed to indicate the occurrence of short latency multi-sensory interactions when presented with salient, high intensity visual stimuli (Bolognini et al., 2010). In an explicit test of stimulus intensity Senkowski and colleagues (2011), presented participants with semantically meaningless but behaviourally relevant audiovisual stimuli of high, medium and low intensities, finding an inverse relationship between stimulus intensity and the magnitude of integrative cross-modal processes. Given that such differences may produce contrasts in both the time course and magnitude of early cross-modal interactions, the research field should strive for greater methodological consistency. Through the presentation of low intensity stimuli may allow for greater convergence of findings.

The temporal specificity of the stim-

ulus presented was highlighted by Bolognini and colleagues (2010), indicating the presence of a critical temporal window (<50ms) for enhanced cross-modal interactions. The study investigated the effect of auditory stimuli on visual perception of phosphenes induced by TMS of the occipital visual cortex. With the modulation of such phosphine perception being maximised when the auditory stimulus preceded the occipital TMS pulse by 40 ms. In each of these cases, the somatosensory stimulation produced perceptual ampliďŹ cation of auditory input. Lakatos and colleagues (2007) further highlighted the role of timing in accounting for such enhanced responses, indicating that visual or somatosensory input can help to â&#x20AC;&#x2DC;drive the ambient oscillations in auditory cortex into the ideal phase for the auditory input, enhancing auditory cortical response.â&#x20AC;&#x2122; Functional Relevance Of Interactions Though such anatomical findings provide evidence for early cross-modal interaction and may serve to expand the current theoretical framework of hierarchical sensory processing, it is necessary to consider the consequences of such processes within the perceptual domain. Alongside these underlying neural processes, it is important to establish the functional significance of cross-modal interactions and how they may contribute to perception in a real world environment containing a vast array of stimuli. A considerable degree of spec-

160 Student Psychology Journal, Volume IV MURRAY ulation exists around such a question, given that research to date has failed to extend itself fully to this domain and provide considered evidence (Driver and Noesselt, 2008). Kayser and colleagues (2008) have further called into question the extent to which such interactions can at present be labelled as integrative, positing that despite indications of speciďŹ city to the temporal or spatial alignment of the stimuli, minimal evidence has been provided so as to establish the extent to which these effects are capable of assisting behavioural responses to stimuli and increasing the capacity of the sensory system to accurately perceive that which surrounds it. Account needs to be taken of sensory combination yielding greater information about the environment as a consequence of combining differing sensory stimuli. In addition, it should be noted that sensory integration reduces the uncertainty in the internal representation of the stimulus, which then enhances the behavioural reaction (Ernst and Bulhoff, 2004). An important starting point from which to address such would be the establishment of the characteristics of these interactions. Research appears to indicate that primary cross-modal interactions lack spatial precision: somatosensory inputs received by the auditory cortex appear scattered in nature (Fu et al., 2003) In addition, lateral connections between primary visual and auditory areas would seem to target the peripheral visual ďŹ eld representations, spe-

cifically avoiding the more precise central visual ďŹ eld representations (Rockland et al., 2003). Thus, on the basis of such poor spatial precision, it is open to question as to the extent to which early cross-modal interactions are capable of aiding the construction of precise higher-order multisensory representations. Such a suggestion is supported through findings from Lakatos and colleagues (2007), indicating that the somatosensory modulation occurring in the A1 region is more related to hearing than it is to the unification of sensory inputs into a singular percept. A hypothesis extending from these findings is that the primary function of such non-auditory inputs is to reinforce unisensory auditory processes. Due to the relatively high level of temporal precision in cross-modal interactions, non-auditory inputs may be capable of maximizing auditory perception through the modulation of oscillatory cycles (Schroeder et al., 2004). The behavioural relevance of early cross-modal integration has been highlighted in studies indicating that these interactions are capable of producing faster performance in a simple detection task (Sperdin et al., 2009). Neuroimaging analysis indicated that the trials producing faster reaction times were not engaging distinct brain networks, but rather such effects were due to the modulation of cross-modal integration occurring within areas already being engaged in unisensory conditions. Interactions between 86 and

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NEURAL BASIS AND RELEVANCE OF CROSS-MODAL INTERACTIONS 128ms were recorded for both fast and slow reaction times but further early interactions (40-80ms) were only recorded for fast reaction times. Though such a study only provides a correlational link, it tentatively suggests that early interactions may indeed be capable of enhancing behaviours when attending to stimuli. Given the emergent nature of the topic there is a large degree of speculation as this body of knowledge expands, with this being particularly the case for functional implications. One current direction of research surrounds early cross-modal interaction and the â&#x20AC;&#x2DC;binding problemâ&#x20AC;&#x2122;. Given the vast array of stimuli present, entering perceptual regions on a continual basis, it remains unclear how the many sensory inputs combine to allow for unified object perception. Foxe and Schroeder (2005) have postulated that cross-modal interactions may play a vital role in this process. Such a suggestion stems from the notion that such integration may prove overwhelming if not carried out until sensory inputs reach higher order processing regions. Thus the early and continued association of sensory inputs, close to the sensory input stage before the occurrence of comprehensive sensory integration may be beneficial for such a process. Though at present this is simply a hypothesis to be investigated, if it were indeed found to be the case, it may serve as the most fundamental behavioural benefit of early cross-modal integration.

Conclusion It is apparent that presently there are more questions than answers within the domain of cross-modal perceptual processes. Though the picture is presently incomplete, alongside the consolidation of theoretical standpoints many findings have served to signpost necessary future research directions. The indication that processes may be mediated by feedback, feed-forward and lateral inputs highlights that cross modal interactions utilize the full range of anatomical connections. While the neocortex does not appear to be as unisensory as once suggested, neither does it appear to be wholly multisensory as initially postulated (Ghazanfar and Schroeder, 2006). The nature of interactions and their modulators appears somewhat region speciďŹ c, thus comparative study of neuronal properties within brain areas may allow for greater comprehension of such processes. The vast degree of mediators, such as the temporal and spatial nature of stimuli, indicate the considerable task at hand to provide a comprehensive overview of such interactions, however, considered multi-modal research may bring greater clarity and allow for the integration of these findings into the perceptual framework, bringing about a new perspective on the nature of perceptual processes and the neural pathways mediating them. References

162 Student Psychology Journal, Volume IV MURRAY Alais, D., Newell, F. N., & Mamassian, P. (2010). Multisensory processing in review: from physiology to behaviour. Seeing and perceiving, 23(1), 3-38. Bolognini, N., Olgiati, E., Rossetti, A., & Maravita, A. (2010). Enhancing multisensory spatial orienting by brain polarization of the parietal cortex. European Journal of Neuroscience, 31(10), 1800-1806. Driver, J., & Noesselt, T. (2008). Multisensory interplay reveals crossmodal influences on ‘sensory-specific’brain regions, neural responses, and judgments.Neuron, 57(1), 11-23. Ernst, M.O., Bulthoff, H.H (2004) Merging the senses into a robust percept. Trends Cogn Sci 8:162–169 Falchier, A. et al. (2002) Anatomical evidence of multimodal integration in primate striate cortex. J. Neurosci. 22, 5749–5759 Foxe, J. J., & Schroeder, C. E. (2005). The case for feed-forward multisensory convergence during early cortical processing. Neuroreport, 16(5), 419. Ghazanfar, A. A., & Schroeder, C. E. (2006). Is neocortex essentially multisensory?. Trends in cognitive sciences, 10(6), 278-285. Giard, M.H. and Peronnet, F. (1999) Auditory–visual integration during multimodal object recognition in humans: A behavioral and electrophysiological study. J. Cogn. Neurosci. 11, 473–490 Kayser, C., & Logothetis, N. K. (2007). Do early sensory cortices integrate

cross-modal information?. Brain structure and function, 212(2), 121132. Kotter R, Sommer F.T., (2000) Global relationship between anatomical connectivity and activity propagation in the cerebral cortex. Philos Trans R Soc Lond B Biol Sci.;355:127–134. Martuzzi, R., Murray, M. M., Michel, C. M., Thiran, J. P., Maeder, P. P., Clarke, S., & Meuli, R. A. (2007). Multisensory interactions within human primary cortices revealed by BOLD dynamics. Cerebral Cortex, 17(7), 1672-1679. Mishra J., Martinez A., Sejnowski T.J., Hillyard S.A. Early cross-modal interactions in auditory and visual cortex underlie a sound-induced visual illusion. J. Neurosci. 2007;27:4120– 4131. Rockland, K.S. and Ojima, H. (2003) Multisensory convergence in calcarine visual areas in macaque monkey. Int. J. Psychophysiol. 50, 19–26 Romei, V., Murray, M. M., Merabet, L. B., & Thut, G. (2007). Occipital transcranial magnetic stimulation has opposing effects on visual and auditory stimulus detection: implications for multisensory interactions. The Journal of neuroscience, 27(43), 1146511472.

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NEURAL BASIS AND RELEVANCE OF CROSS-MODAL INTERACTIONS Schroeder, C. E., Molhom, S., Lakatos, P., Ritter, W., & Foxe, J. J. (2004). Humanâ&#x20AC;&#x201C;simian correspondence in the early cortical processing of multisensory cues. Cognitive Processing, 5(3), 140-151. Senkowski, D., Saint-Amour, D., HĂśfle, M., & Foxe, J. J. (2011). Multisensory interactions in early evoked brain activity follow the principle of inverse effectiveness. Neuroimage, 56(4), 2200-2208. Sperdin, H. F., Cappe, C., Foxe, J. J., & Murray, M. M. (2009). Early, low-level auditory-somatosensory multisensory interactions impact reaction time speed.Frontiers in integrative neuroscience, 3. Stein, B. E., & Meredith, M. A. (1993). The merging of the senses. Stein, B. E., Burr, D., Constantinidis, C., Laurienti, P. J., Alex Meredith, M., Perrault, T. J. & Lewkowicz, D. J. (2010). Semantic confusion regarding the development of multisensory integration: a practical solution. European Journal of Neuroscience, 31(10), 1713-1720. Vasconcelos, N., Pantoja, J., Belchior, H., Caixeta, F. V., Faber, J., Freire, M. A. M. & Ribeiro, S. (2011). Cross-modal responses in the primary visual cortex encode complex objects and correlate with tactile discrimination.Proceedings of the National Academy of Sciences, 108(37), 15408-15413.

Student Psychology Journal, 2013, 164- 175

Are Fathers Necessary For Positive Child Development? Alan Walsh Trinity College, Dublin Correspondence: walsha31@tcd.ie

“I am indebted to my father for living, but to my teacher for living well.” - Alexander the Great Introduction Origins and Methodological Criticisms of the Fathers’ Debate Unlike mothers, popular opinions of fathers appear to vary widely among public consensus. From one extreme, Freud (1930/1961a) notes “I cannot think of any need in childhood as strong as the need for a father’s protection” (p32). But on the other hand, the very fact that we must ask ourselves “Are fathers necessary?” clearly testifies to the deprived position they have in society in comparison to mothers. The father’s role it seems is considered inferior to that of the mother’s. There are those who of course will argue otherwise and indeed the urgency for involved fathering is a fundamental aspect to the protests of father’s rights activists. What this essay will argue however, is that fathers should not be viewed in terms

of their gender. Fathers are restricted by this definition, and just like mothers they should be viewed in terms of parents – a term that eliminates the confines of gender. The essay will begin by first scrutinising the methodological faults of the many studies that preach the necessity of fathers. It will then introduce several studies that might be considered as more reliable to use in the debate about the necessity of fathers. The sociological implications of the discourse of “father” will also be a theme of this essay, highlighting the need to deconstruct this. Pleck (2004) notes that popular and scholarly discussions of fatherhood have long focused and dwelled on the importance of fathers’ “involvement”. This involvement is often defined in terms of inadequate or absent fathers. When debating over the necessity of fathers for child development, it may indeed first

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FATHERS AND CHILD DEVELOPMENT appear logical to begin by analysing findings of studies that simply deal with levels of father involvement. In other words, by comparing the behaviour of children with or without fathers, we can then directly investigate the influence that fathers have on their offspring. Indeed an overwhelming volume of literature has consistently found that children who are raised with their fathers are far better off than those who are raised without fathers. Studies have shown that the positive involvement of fathers can benefit childrenâ&#x20AC;&#x2122;s IQ/cognitive functioning (Pougnet et al, 2011), can lead to less externalising and internalising childhood behavioural problems (Hofferth, 2006), can reduce later substance abuse in children (Goncya & Van Dulmena, 2010), reduce childhood obesity (Wake et al, 2007), reduce later criminal delinquency (Coley & Medeiros, 2007) and even reduce maternal physical child abuse (Guterman et al, 2009). From a socioeconomic standpoint it may also appear that fathers are vital, with the positive involvement of a father associated with better access to health care (Gorman & Braverman, 2008), reduction in household poverty (Edin & Kissane, 2010), and significantly reducing the likelihood of a child repeating a year in school (Nord & West, 2001). At first glance, it may indeed appear that fathers are crucial to ensure the stability of healthy child development - children without a father do worse, children with a father do better. However, it takes much more than a glance to approach this debate

in a more logical and reasoned way. The assumption of these studies is, essentially, that itâ&#x20AC;&#x2122;s possible to compare the behaviour and personalities of children raised with or without fathers, and conclude that the differences these children display are due to their relative disparities in father involvement. The studies mentioned above all however exhibit one common flaw that leads to the misrepresentation of their results. This flaw is that they, like so many studies on fathers, compare a married two parent family to a single one parent family. The studies may then conclude that fathers are vital because absence of them leads to so many negative consequences. However, as Biblarz & Stacey (2010) argue, our ideas of what fathers do and provide cannot be based primarily on contrasts between married-coupled parents and single-female parents. This is largely an apples-to-oranges exercise that conflates number of parents, marital status, gender and sexual orientations. Biblarz & Stacey (2010) consolidated the available data on the role of gender in child rearing and noted that most of the data falls short of distinguishing between a father and the income a father provides, or distinguishing between the involvement of a father and the involvement of a second parent.

Parent and Father: Examining the Difference

166 Student Psychology Journal, Volume IV WALSH It could be argued that it is not the lack of a loving father that leads to the negative outcomes for the child, but rather the lack of a loving parent. It is this absence of a co-parent that should be viewed as the bigger culprit for the problems found in children raised by a single parent. Possible benefits can clearly be seen from having a partner to help out with child care, perhaps participate in tough decisions, and to relieve the other of the regular demands of child care. The “absent father” must therefore not be viewed in terms of gender, but rather with reference to the roles and duties of a parent that are left vacant due to this absence. Absence of one parent means that all economic, social and emotional parental roles must now be filled by a single, strained parent. Approaching comparative studies of family structures in this way is crucial to an informed understanding of how fathers may influence child development. In another critique of comparative studies, Lamb (2010) notes how most single parent families stem from divorce. Since divorce is so frequently accompanied by periods of overt and covert spousal hostility, parental conflict may play a major role in explaining the apparent problems of “fatherless” children. Substantial literature supports the links between interparental processes, including marital quality and interparental conflict, and also child and adolescent adjustment (Cummings & Davies, 1994; Grych & Fincham, 1990).

Therefore we cannot assume that children’s behavioural problems are a result of their now “non-residential father”. A hostile, tense environment is much more likely to be the reason for these problems. Marital conflict leads to greater stress for both partners, and as a result they may become less capable of looking after their children. These detrimental effects of pre-divorce and post-divorce conflict are well documented (Cummings & Davies, 2011; Kelly, 2000). Once again it is not the absence of a father that is a direct cause of childhood problems, but rather the underlying factors that happened to lead to this absence, i.e. marital conflict and divorce. For example children in single parent families whose father has died previous can fare better than those in single parent families directly following a divorce (Rutter, 1971; Biblarz & Gottainer, 2000). Children tend to suffer when fathers are unsupportive during marital conflict (Cummings & O’Reilly, 1997) and there is also a wide body of marital conflict research that has outlined several possible adverse effects on child development, such as increased risk of substance abuse (Barrett & Turner, 2006), mental health problems (Amato, 2001) and high-risk sexual behaviour (Hetherington, 1999). In addition to this, the perceived and often actual abandonment by one of their parents emotionally affects children (Kelly & Lamb, 2000; Thompson & Laible, 1999).

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FATHERS AND CHILD DEVELOPMENT It appears that marital conflict is associated with child maladjustment, while marital harmony is associated with child adjustment. Perhaps we can reference Bandura’s (1977) influential Social Learning Theory to note that if people, especially children, learn within a social context, it is vital for their learning to be facilitated by positive influential models. The positive influence of a parent is somewhat eroded by marital conflict. Behavioural problems arise from this conflict and it is this conflict that can be seen as an underlying factor in the perceived developmental problems of children who do not live with their fathers. Once again, we must not use studies of divorce as a way of advocating the necessity for fathers. Instead we should use them to demonstrate that children simply need a loving, nurturing and hostile-free environment, which is best easily facilitated through a healthy relationship between two loving parents, regardless of gender.

exclusively possess unique and essential qualities that mothers do not. The idea that fathers, by virtue of being male, make an essential contribution to child development has been present in the literature since at least the 1940s (Pleck, 1981). Silverstein and Auerbach (1999, p.197) summarise this “essentialist” notion in their critical analysis, “fathers are understood as having a unique and essential role to play in child development, especially for boys who need a male role model to establish a masculine gender identity”. This idea of the essential father is certainly very topical among public discussion, and the idea has several scholarly advocates (Blankenhorn, 1995; Popenoe, 1996; Wilson, 2002). These advocates claim that fathers are necessary for children’s development due to their unique, and more importantly, male qualities. The essentialist perspective argues that fathering and mothering are distinct biological and social roles, ones that are not interchangeable.

Essential Father: Fact or Fiction Let us now approach this essay’s theme of “parent rather than father” through a different lens. We have seen how it is a flawed idea to compare children of coupled-parents to children of single parents, due to the fact that there are so many underlying differences at play (the absence of a father being just one of many). To argue that fathers are necessary for child development would suggest that fathers

To argue for or against this notion, we must first eliminate the effects of having a male parent or not. Again keeping in mind the methodological need for reliable comparative studies, such comparisons can be made only between pairs of family structures that hold constant the number of parents, but vary in whether they include a male parent. Adequate comparisons include single fathers and single mothers, male two-parent gay families and two-parent lesbian families, and two-parent het-

168 Student Psychology Journal, Volume IV WALSH erosexual families and two-parent lesbian families. Comparisons of the latter provide little support that a male father is necessary for healthy development. Children raised by lesbian mothers do not tend to display a greater number of negative developmental outcomes in comparison to their heterosexual-parented counterparts (Patterson & Chan, 1999; Stacey & Biblarz, 2001; American Academy of Pediatrics, 2002). Furthermore, boys raised by lesbian couples do not possess fewer male characteristics than others (MacCallum & Golombok, 2004). Seeing as the concept of lesbian mothers raising a child is relatively new and possibly contentious in society, it could be argued by some that competent lesbian mothers tend to be extremely motivated to simply volunteer for such studies in order to prove their adequacy. Supporters of the essential father debate may therefore argue that the results are biased. However, one set of studies (Wainright, Russell, & Patterson, 2004; Wainright & Patterson, 2006, 2008) rigorously drew out a large scale representative sample of adolescents and their families in the National Longitudinal Survey of Adolescent Health. Children of lesbian couples were contrasted with children of heterosexual couples on many variables such as self-esteem, anxiety, trouble in school, school connectedness, depression and neighbourhood integration. Results showed absolutely no significant differences between the two

groups of adolescents. Furthermore, later investigations (Wainright & Patterson, 2008) showed that children of lesbian couples actually exhibited less substance abuse and delinquency than the children raised by a women and a man. A healthy adolescence clearly stems from a healthy childhood, and it seems that this is perfectly possible without the presence of a father. As mentioned earlier, we can also use comparative studies of single parents because the number of parents remains constant but the gender of the parent does not. Again the results do not bode well for proponents of the essential father debate. In comparison to single mothers, single fathers display a greater difficulty in monitoring their childrenâ&#x20AC;&#x2122;s school progress, friends, and whereabouts ( Maccoby & Mnookin, 1992), display poorer involvement, rule setting and closeness (Hawkins et al.,2006), and have lower educational expectations for their child (Downey, 1994). In addition to this, children of single fathers display worse grades (Downey, 1994; Pike 2002), worse teacher ratings (Downey et al., 1998) and display a greater likelihood of substance abuse (Hoffmann, 2002). These studies all hold possible variances of socioeconomic attributes constant that may exist between single mothers and single fathers. The findings above are quite catastrophic for the essentialists, the studies do

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FATHERS AND CHILD DEVELOPMENT not even support popular claims that fathers are somehow better able to keep boys in line or command respect from their children. However, it must be repeated once more that children of single mothers still fare worse than children of coupled heterosexual parents. So even though studies of single parents appear to be detrimental to the essential father, there is still evidence that fathers do play some role in the healthy development of a child. This role however is likely to not be grounded in maleness, but rather on the father’s capacity to act as a responsible, loving and caring parent. A more reasonable alternative to the essential father hypothesis may be what Pleck (2010) suggests as an “important father” hypothesis. Pleck’s view holds that good fathering is simply one of many factors promoting positive child outcomes, and these outcomes are not necessarily linked to the father’s masculinity. In a large-scaled study based on longitudinal evidence Sarkadi et al. (2008) reviewed 24 publications of father involvement. 22 of these described positive effects of father involvement and the review went on to recommend that policy makers should strive for greater involved fathering. From this evidence we can indeed see how fathers might be deemed “necessary” by essentialists and father’s rights activists. But perhaps the term “involved parenting” would be more suitable than involved fathering. Likewise “important” might be

more reasonable to use than essential. Deconstructing the Discourse of Father Lesbian couples demonstrate that gender does not play an essential role in child development. In fact Biblarz & Stacey (2010) point out that based strictly on the published science, one could even argue that two women parent better on average than a woman and a man. Less is known about male homosexual couples, and Biblarz & Stacey acknowledge that this is a slim body of research. Of the few studies that do focus on gay male parents, results show that the children they raise do not tend to exhibit any significant behavioural problems as a result of having no mother (Johnson & O’Connor, 2002; Stacey, 2006). By analysing the findings from studies of both lesbian mothers and gay fathers, we can demonstrate that the gender of a parent is not a significant factor. Two lesbian mothers should not be viewed in terms of their femininity, much like gay fathers should not be viewed as a “double dose” of masculinity Stacey (2006) notes a “passion for parenthood” (p27) that is seen among gay men, and indeed straight men too. The discourse of a “father” is therefore flawed because it restricts men to their gender. Men and women alike should instead be viewed in terms of their desire to be parents, not their desire to be mothers or fathers. This is summed up nicely in Stacey’s (2006) aptly titled article, “Gay Parenthood and the Decline of Paternity as

170 Student Psychology Journal, Volume IV WALSH We Knew It”. Without ‘masculine’ contributions of boisterous play and ‘feminine’ yearnings for nurture and care, paternity, but certainly not male parenthood, might become obsolete. In their analysis of children’s cognitive outcomes, Martin, Ryan & Brooks-Gunn (2007) also concluded that “among children with one supportive parent, the sex of that parent was inconsequential” (p423). Findings like this heavily erode Popenoe’s (1996) argument that two married, biological parents are the gold standard for childrearing. Therefore the lack of a female parent is not important for gay fathers, much like the lack of a male parent is not important for lesbian mothers. Mallon (2004) notes how gay fathers can sometimes consider themselves more similar to mothers than to fathers – “As a gay dad, I’m not a mom, but sometimes I think I have more in common with moms than I do with straight dads” (p138). Statements such as this testify to the notion that we must deconstruct the societal discourses that define “fathers”. Articles and arguments about “Are Fathers Necessary?” are unfair because they put men into the same trap that women have been clambering out for years. They reduce us to our biology, and relevant stereotypes are fortified by branding fathers and mothers as opposite entities. Of course in the past, decades ago, the differences between fathers and mothers were more blatant with the traditional nuclear family being dominated by a breadwinning father

and a home-making, child-rearing mother. Society had indeed once viewed fathers as all-powerful patriarchs who are entitled to yield unconditional dominance over their families (Knibiehler, 1995), but these roles have since changed. In line with this change, researchers began to realise the newly found potential of the father as a parent. In such a context, it must have been easy for Michael Lamb to entitle his first essay on the subject, “Fathers: Forgotten Contributions to Child Development” (Lamb, 1975). Nowadays researchers do not constrict fathers to their uni-dimensional role of breadwinning. Instead they are recognised in terms of care providers, companions, protectors, moral guides, models, teachers – as well as breadwinners. Mothers play identical roles to those listed above and so it should be important to identify that these are the roles of a parent. Certain roles are no longer exclusive to a mother or to a father and therefore the gender of a parent is a trivial characteristic. In a much more recent essay, Lamb (2010) notes “the differences between mothers and fathers appear much less important than the similarities” (p10). Conclusion Taking into consideration the societal forces that may surround and define fathers, the question of “Are Fathers Necessary for Positive Child Development” can be viewed as similar to the question of “Is Gender Necessary for Positive Child De-

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FATHERS AND CHILD DEVELOPMENT velopment”. The extensive volume of research outlined above would argue that the answer to both of these questions appears to be a resounding no. There is an oversimplified obsession with a masculine rolemodel among public consensus. We should however be looking for good parents, not fathers. Parental warmth, closeness, and nurture are associated with positive child outcomes regardless of whether the parent involved is a mother or a father. Even some past proponents of the necessity of fathers have begun to realise the insignificance of gender. Pruett (2000), a prominent advocate of involved fathering, writes “I also now realise that most of the enduring parental skills are probably, in the end, not dependent on gender” (p18). Perhaps others will follow suit, and maybe in the future the support of the traditional nuclear family will be unanimously considered as an out-dated cultural artefact. At this point no research supports the widely held conviction that the gender of parents matters for children’s well-being. Are fathers necessary for positive child development? Probably not. Are parents? Most definitely. References

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174 Student Psychology Journal, Volume IV WALSH Pleck, J. (2010). Fatherhood and Masculinity. In M. Lamb (Eds.) The Role of the Father in Child Development, (pp. 27-57). New Jersey: John Wiley & Sons. Pleck, J.H. (1981). The myth of masculinity. Cambridge, MA: MIT Press Popenoe, D. (1996). Life without father: Compelling new evidence that fatherhood and marriage are indispensable for the good of children and society. New York: Free press. Pougnet, E., Serbin, L. A., Stack, D. M., & Schwartzman, A. E. (2011). Fathers’ influence on children’s cognitive and behavioural functioning: A longitudinal study of Canadian families. Canadian Journal Of Behavioural Science/ Revue Canadienne Des Sciences Du Comportement, 43(3), 173-182. Pruett, K. D. (2000). Fatherneed: Why father care is as essential as mother care for your child. New York: Free Press. Rutter, M. (1971). Parent-Child Separation: Psychological Effects on the Children. Journal of Child Psychology and Psychiatry and Allied Disciplines. 12, 233-260. Sarkadi, A. , Kristiansson, R. , Oberklaid, F. , & Bremberg, S. (2008). Fathers’ Involvement and Children’s Developmental Outcomes: A Systematic Review of Longitudinal Studies. Acta Paediatrics. 97, 153–158. Silverstein, L. B., & Auerbach, C. F. (1999). Deconstructing the essential father. American Psychologist, 54, 397-407.

Stacey, J. (2006). Gay male parenthood and the decline of paternity as we knew it. Sexualities, 9, 27–55. Stacey, J., & Biblarz, T. (2001). (How) does the sexual orientation of parents matter? American Socioloical review, 66, 159-183. Teachman, J. D. (2004). The Childhood Living Arrangements of Children and the Characteristics of Their Marriages.” Journal of Family 25, 86-111. Thompson, R. A., & Laible, D. J. (1999). Noncustodial parents. In M. E. Lamb (Ed.), Parenting and child development in “non-traditional” families (pp. 103-123). Mahwah, NJ: Erlbaum. Wake, M., Nicholson, J.M., Hardy, P., & Smith, K. (2007). Preschooler obesity and parenting styles of mothers and fathers: Australian national population study, Pediatrics, 12, 1520-1527. Wainright, J. L., & Patterson, C.J. (2006). Delinquency, victimisation, and substance use among adolescents with female same-sex parents. Journal of Family Psychology, 20, 526-530. Wainright, J. L. & Patterson, C. J. (2008). Peer relations among adolescents with female same sex parents. Developmental Psychology, 44, 117-126. Wainright, J.,Russell, S., & Patterson, C. J. (2004). Psychosocial adjustment, school outcomes, and romantic relationships of adolescents with samesex parents. Child Development, 75, 1886-1898.

Review Articles FATHERS AND CHILD DEVELOPMENT Wilson, J. Q. (2002). The marriage problem: How our culture has weakened families. New York: Harper-Collins

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Culture and Mental Health: a Symbiotic Relationship Sarah-Jane Winders Trinity College, Dublin Correspondence: winders@tcd.ie

Introduction Debate about the influence of culture on an individualâ&#x20AC;&#x2122;s mental health has sparked a division among psychologists; with one side viewing the common human physiology as evidence of common manifestation of psychopathology and the opposing side posturing that culture has a powerful impact on the development of the individual, and thus psychopathology must be understood within the context of its manifestation (Alarcon, 1996; Thakker & Ward, 1998). This divides the psychologists (albeit crudely) into universalists and relativists respectively. This raises the question, what are the implications for mental health? The universalist approach is most prevalent, due in part to the popularity of nosology and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). The most recent text revision and the newest edition1 attempted to incorporate culture,

The DSM-V was in preparation when this manuscript was written and so there

yet there is much criticism for the ethnocentric Western perspective, giving precedence to disorders common in the west (set as universals) and labelling disorders found elsewhere as culture bound. Given the attractiveness of a universal classification system, where does this leave culture when evidence has been found to support its impact on mental illness (MacLachlan, 2006). Schizophrenia, once thought to be a universal disorder has been revealed to vary across cultures in onset, course, symptoms and recovery (Thakker & Ward, 1998), so providing evidence of cultural influence. It could be argued that mental illness has never been the same the world over or in the past, either in prevalence or in form; that it is shaped by the symptom repertoire (Shorter, 1997) or symptom framework of the culture.

Culture Little consensus has been met regard-

is only a brief mention of the changes made regarding culture in the new edition.

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CULTURE AND MENTAL HEALTH ing a definition of what is meant by the term culture. Kroeber and Kluckhohn (1952, as cited in O’Dell, 2004) illustrated this diversity of definition by reviewing 161 definitions of the concept and Allen (1992, as cited in MacLachlan, 2006) later distilled these into seven broad conceptual categories. Historically, culture has been defined in a myriad of ways but is generally considered a framework through which people can relate to each other, or a set of guidelines for living in the world (MacLachlan, 2006). Brislin (1990) defines it as a medium for transmission of ideas from generation to generation without there being explicit instruction. It has also been postulated as learned systems of meanings, providing people with a distinctive sense of reality to shape their behaviour, values, beliefs and emotional responses (Fabrega, 1991; Triandis, 1972). Individual experience and existence is permeated by culture and understanding this is integral to the study of cultural psychology. MacLachlan (2006) emphasises that culture is essentially pragmatic and ultimately provides a means of communicating with those around you. Shweder, one of the major proponents of the field, stated cultural psychology was the study of how “psyche and culture, person and context (...) require each other (...) dynamically, dialectically and jointly make each other up” (Stigler, Shweder, & Herdt, 1990). Shweder postulated that the content of the human mind is not essential-

ly the same across the world and different cultures create different mentalities, there are no global traits and one cannot generalise across contexts. No sociocultural environment is independent of the human beings who glean meaning from it, likewise, an individual’s mental life is transformed and constructed through the meanings and interactions with the sociocultural environment (Shweder, 1995). Shweder goes even further to describe the psyche as the intentional person and the world as the intentional world, they are “interdependent things that get dialectically constituted and reconstituted” through the activities and actions that make them up. The question posed is, what does this imply for health and more specifically mental health (It should be noted that Shweder is not alone in this view, although his stance leans to the side of extreme relativism). Universalists Vs. Relativists A prominent debate in the cross-cultural study of mental illness and psychopathology is the conflict between those who support universality in psychology and those who, like Shweder, support relativism. Universalists seek similarities across cultures to form form cross-cultural generalisations; they pose that variation in symptoms across cultures is superficial. Thakker and Ward (1998) state that Universalists are more interested in their own cultures than those of others as they use them as a testing ground for Western ideas.

178 Student Psychology Journal, Volume IV WINDERS Relativists in contrast aim to understand psychopathology within the cultural framework in which it manifests itself. There is an assumption that the culture may have a significant impact on the mental illness and so is heterogeneous just as cultures are. This division echoes the split between the biomedical and biopsychosocial health models. Where the biomedical model focuses on purely biological factors, and so assumes that the entire organism could be explained in terms of its parts (Fava & Sonino, 2007), whilst the biopsychosocial model proposes that any clinical investigation must include the individual, their body and their surrounding environment as essential components of the total system. The model advocated the need to include consideration of function in daily life, productivity, performance of social roles, intellectual capacity, emotional stability and psychological well-being. The universalist position and the biomedical model are the most dominant in Western culture however, given the prominence of the classification of mental illness. Diagnostic and Statistical Manual of Mental Disorders â&#x20AC;&#x201C; The Popular Choice The Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV; American Psychiatric Association, 1994) is considered invaluable in psychiatry and its common usage has surpassed the International Classification of Diseases (ICD-10;

World Health Organization, 1992) in some countries (Lewis-FernĂĄndez & Kleinman, 1995). This could be problematic as the DSM is a Western construct and many mental disorders in it are rarely found outside the West (e.g. eating disorders Alarcon, 1995). Following criticisms of the DSM-III-R (American Psychiatric Association, 1988) for not being sufficiently applicable to different, non-Western cultures and ethnicities, the fourth edition was compiled with cross-cultural applicability in mind. The DSM-III-R included two paragraphs on culture, cautioning clinicians that using the DSM with other cultural groups could lead to misdiagnosis and they should be sensitive to differences in language, morals and conduct (Rogler, 1996). The DSM-IV, in comparison, pays greater attention to culture, remarking on cultural difference in relation to disorders; the introduction highlights the importance of culture in clinical practice and an appendix is devoted to a glossary of culture bound syndromes (Kleinman, 1997). This was not the revolutionary text anticipated by the Task Force (Thakker & Ward, 1998) set with the charge of enhancing the DSMs applicability internationally. In a quantitative analysis, Alarcon (1995) estimates, as little as 27.5% of the suggestions made byhe Task Force made it into the DSM-IV. Researchers have argued that the inclusion of a diluted and less effective cultural element perpetuates the perceived superficiality of difference (Thakker & Ward, 1998).

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CULTURE AND MENTAL HEALTH The most recent edition of the DSM, DSM-V has however met with controversy for several reasons, one of which was the fact that the criteria for disorders are based on consensus rather than objective laboratory measures as other medical disorders are (Insel, 2013). Those opposing the use of the DSM as the â&#x20AC;&#x2DC;gold standardâ&#x20AC;&#x2122; (Kapur, Phillips, & Insel, 2012), state that the diagnostic system has to be based on the emerging research data (genetic, imaging, physiologic, and cognitive data), not on the current and arguably outdated symptom-based categories (Insel, 2013). Criticisms were also made concerning the increasing tendency to pathologise patterns of behaviour and mood that are not considered to be particularly extreme (Frances & Widiger, 2012). These detractors of the most recent edition may herald a modern and contemporary nosology but it remains to be seen whether this will benefit the relativists in cultural psychology. One problem with universality and the DSMs cross-cultural applicability is an assumption at its core, its biomedical model that poses that all mental disorders have a fundamentally biological basis (Follette & Houts, 1996). This implicit assumption is then, given our common physiology, that our psychopathology is homogenous and perceived difference is superficial. A criticism of this is that most mental disorders have not yet been found to have biological correlates (Thakker & Ward, 1998). This focus on individualist model (locating the origin of psychopathology in the individ-

ual) does not take cultural factors into account (MacLachlan, 2006). Schizophrenia â&#x20AC;&#x201C; A Universal Disorder? Schizophrenia is a well-researched example of a disorder varying significantly across cultures. Initially thought to support the universality of mental disorders (Defenderf & Kraepelin, 1902), over a century of research has followed, emphasising more difference in onset, course, symptoms and recovery across cultures than originally considered. On first investigation there appeared to be a correlation between schizophrenia and Western influence; researchers uncovered that Western influence appeared to increase rates of schizophrenia (Thakker & Ward, 1998). When researched cross-culturally, there has been a trend observed, schizophrenia is prevalent in urban areas and in individuals who recently moved to cities from rural areas (Burton-Bradley, 1969). In a large cross-cultural study by the WHO (World Health Organization; Sartorius, Shapiro, & Jablensky, 1974) one of the main findings was that the outcome for schizophrenics in developing countries was significantly better than the outcome for those in developed countries. The results were supported in another cross-cultural study building on these findings, the course of the syndrome in patients from less industrialised cultures was significantly better than in the industrialised West

180 Student Psychology Journal, Volume IV WINDERS (Sartorius, Jablensky, Korten, & Ernberg, 1986). There was distinct brevity observed in the schizophrenic patientâ&#x20AC;&#x2122;s course. Culture appears to have influenced mental health through cultural expectations and community (Thakker & Ward, 1998). In non-Western cultures, where there are larger families and more supportive community environments, there is less excessive emotionality (EE) which is thought to act as a stressor for the schizophrenic so perpetuating the illness (Kymalainen & Weisman de Mamani, 2008). The lower levels of (EE) are thought to be a correlate of the supportive community environment where responsibility is shared; the patient is encouraged to reintegrate with the community and family, and expectations for recovery are higher, which is thought to encourage recovery (Luhrmann, 2007; Waxler, 1979). The chronicity of schizophrenia is thought to be a result of the social responses and reactions to the illness. Myers (2010) writes that the culture that helps people manage their stress may promote better prognoses through the promotion of resilience. Schizophrenics in developing countries are more likely to be married than in the developed countries as their families know this will be a protective factor and shield from the stigma of having the disorder (Myers, 2010). As was earlier noticed by Bur-

ton-Bradley (1969), symptoms of schizophrenia varied across cultures, in developing countries they could manifest acutely and disappear quickly and were more likely to be as result of a stressful life event (Kleinman, 1988). This form of schizophrenia appears to have a rapid onset following a traumatic event and is associated with complete recovery. How the symptoms manifest in the individual, is another cultural difference. Research has illustrated with various cultural samples that schizophrenic symptoms appear to be particularly influenced by culture. One study in India (Kulhara, Mattoo, Awasthi, & Chandiramani, 1987) reported significantly more cases of catatonia and persecutory delusions. Similar studies have shown a prevalence of auditory hallucinations in Europe, visual hallucinations in West Africa and cenesthetic hallucinations were common in Ghana (Bauer et al., 2011). Researchers have also shown ethnic-minority groups to be less symptomatic than non-minority groups (Brekke & Barrio, 1997). This is a significant body of evidence for the variability of the disorder schizophrenia. Onset of disorder appears to have differing triggers, the symptoms manifest themselves differently for each culture and the environmental variables of family and community can significantly affect recovery, either hampering or improving it. The universality of this considered universal disorder has not been empirically

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CULTURE AND MENTAL HEALTH (Thakker & Ward, 1998). On the basis of this research it could be concluded that Shweder’s statement was correct, there is significant support for the symbiotic relationship between culture and psyche. Culture Bound Syndromes What is provided by the universalism of the DSM-IV is not sufficient in light of Shweder’s statement and culture bound syndromes are an illustration of this. The separation of the culture bound syndromes in the DSM-IV can be criticised as all syndromes are influenced by the context in which they occur, not only those viewed ethnocentrically, which are deemed odd or unfamiliar from the Western perspective (MacLachlan, 2006). By differentiating culture bound syndromes there is an implication that all others are uninfluenced by culture and so universal, for example depression (Malik (2000), argues that the notion of depression is not an adequate description of mental health issues for indigenous Pakistani and first-generation British Pakistani). This is a dangerous assumption and as MacLachlan (2006) states, the clinician is also influenced by their own cultural context. The DSM-IV also recommends some culture bound syndromes to be deciphered and interpreted in terms of those DSM categories considered universal. This involves “shoehorning” or adapting a syndrome to fit into an already existing category, which may not be able to accommodate it. Presuming universality

is misguided, as some of the syndromes in the DSM-IV are culture bound to Western culture and are not identified as such: anorexia nervosa, type A behaviour, obesity, agoraphobia, kleptomania and exhibitionism (or exposing oneself; list as detailed in MacLachlan, 2006). It is this ethnocentric position of universalism, focused on Western diagnostics that has overlooked the influence of culture. All syndromes are influenced by the culture and context in which they occur (Sutker & Adams, 2001), as Shweder stated, “psyche and culture are seamlessly interconnected” (Shweder, 1995). MacLachlan (2006) states, all syndromes have both an order and function, in other words within the cultural context they make sense and have a purpose. This can be seen in numerous examples of syndromes considered foreign and indiscernible, for example, pibloktoq (Arctic hysteria), a condition found in the Inuit women of Greenland where they ran wildly across the tundra, screaming incoherently, tearing at their clothing and eating excrement. This behaviour would appear to be disturbed, yet on further investigation it was postulated to be a reaction to the sexual abuse the women had suffered at the hands of explorers, the behaviour is now seen to make sense as a reactionary response and served the purpose of a defence by dissuading the men from attacking them again. The women’s behaviour is an expression of their psychological distress precipitated by the

182 Student Psychology Journal, Volume IV WINDERS stress and change (Dick, 1995 cited in MacLachlan, 2006). For the relativists like Shweder, the experience of mental illness is highly subjective. The expression of the symptoms depends largely on the society or culture that the person is a part of and what is deemed acceptable or unacceptable. This above behaviour is a corollary of the Inuit women’s psychic distress, it is not universal and cannot fit into any universal classification system and so needs to be looked at from a culturally sensitive position to be correctly understood. Researchers have referred to historical cases of psychopathology that do not manifest themselves anymore, or perhaps have changed their symptoms and manifestation (Davison, 2006; Roffe & Roffe, 1995). The mind is drawn toward the symptoms that effectively communicate its distress at the given time and in the appropriate context. Symptom repertoire is defined as a range of physical symptoms available to the unconscious mind for the physical expression of psychological conflict (Shorter, 1986). This does not mean that these symptoms or illnesses are not real, or that those suffering deliberately shape their symptoms to fit a certain cultural niche, rather it indicates that a mental illness is an affliction of the mind and must be understood in light of the ideas, habits and predispositions and so the idiosyncratic cultural trappings of that particular mind. A modern example of the concept of

symptom repertoire is the case of anorexia in Hong Kong (Kam & Lee, 1998; Lee, 1995a, 1995b; Ngai, Lee, & Lee, 2000). Anorexia nervosa (AN) was initially considered a Western, culture bound, entity. A type of food refusal was observed outside of the West, but cases were rare and did not meet DSM criteria for AN. The DSM-IV criteria for AN require: body-image distortion, an intense fear of gaining weight and fear of fat. Lee (1995b) found that the Chinese patients did not have the same motivation as typical Western AN patients, exhibit the same symptoms nor fit the diagnostic criteria. The Chinese patients had not heard of the diagnosis of AN and their symptoms where predominantly somatic. Since Lee’s paper in 1995 (1995b) the prevalence of AN has risen in Hong Kong and cases of the Western typical formation are on the rise (Kam & Lee, 1998; Ngai et al., 2000), particularly among young females in high-income Asian societies such as Singapore, Japan, Taiwan and Hong Kong (Lee, Ng, Kwok, & Fung, 2010). These AN patients are now exhibiting the psychopathological patterns historically described in Western cases. Lee et al., (2010) highlights that the clinical presentation in China has gradually (since the 80s) conformed to the patterns seen in the West. They relate this to the “rigorous media promotion of slimness”, fuelling a phobia of fatness and the concomitant weight control behaviour. There is a new

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CULTURE AND MENTAL HEALTH social pressure towards slimness in Chinese youth culture. Lee et al., (2010) asserts that culture shapes our psychopathology, the modern culture which publicises eating disorders could be establishing the symptom repertoire and people could unconsciously and organically choose/ use eating disorders as their symptom to express their psychological conflict. The Western formation of AN was not prevalent in the past as it was not part of the culture and/or the times’ symptom repertoire. Conclusion Shweder’s statement “psyche and culture, person and context (...) require each other (...) dynamically, dialectically and jointly make each other up” raises a problem for the universal cross-cultural approach to mental health. The body of research on cultural relativism is growing, and there is increasing evidence of problems with cross-cultural applicability. The DSMs previous attempts at incorporating culture into their nosology have not been sufficient. If the implications of Shweder’s statement are to be incorporated into the treatment of mental health, culture would be seen as a legitimate partial cause of disorders, then each culture “may have its own particular, although overlapping, types of mental disorders” (Thakker & Ward, 1998). For a mental illness to be understood, if must be investigated within the relevant social context, from a culturally sensitive position. Individuals use what

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